NPIMap

Organization Active NPI

Employee Assistance Resource Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Smithtown, NY
National Provider Identifier
1720196942
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
061110768 Issued in NY
Legal business name
EMPLOYEE ASSISTANCE RESOURCE SERVICES
Practice address
278 E Main St
Smithtown, NY 11787-2920
Phone
(631) 361-6960
Fax
(631) 366-5346
NPI assigned
Aug 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Simon A. Zysman, PH.D.NPI 1487762670
Title
Executive Director
Phone
(631) 361-6960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 061110768 NY Primary

Addresses

Primary practice location

278 E Main St
Smithtown, NY 11787-2920

Mailing address

278 E Main St
Smithtown, NY 11787-2920
Phone (631) 361-6960

Other identifiers 1

IdentifierTypeStateIssuer
01427518MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000705 NY Part B Supplier - Clinic/Group Practice 3476441056 Receives reassigned benefits from 6 practitioners
Practice locations: Smithtown, NY

National Provider Directory

National Provider Directory

Locations

278 E Middle Country Rd
Ste B
Smithtown, NY 11787
Phone (631) 361-6960

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1720196942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 E MAIN ST",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872920",
            "telephone_number": "631-361-6960",
            "fax_number": "631-366-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 E MAIN ST",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872920",
            "telephone_number": "631-361-6960",
            "fax_number": "631-366-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPLOYEE ASSISTANCE RESOURCE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "ZYSMAN",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "631-361-6960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "061110768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01427518",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.