NPIMap

Organization Active NPI

CHS Physician Partners, PC

Doing business as Bellmore Family Practice

  • Family Medicine Physician
  • Bellmore, NY
National Provider Identifier
1720334527
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CHS PHYSICIAN PARTNERS, PC
Doing business as
Bellmore Family Practice
Practice address
2053 Bellmore Ave
Bellmore, NY 11710-5603
Phone
(516) 679-3627
Fax
(516) 679-3631
NPI assigned
Jul 30, 2012
Last updated
Jul 19, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
CHS PHYSICIAN PARTNERS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Authorized official

Name
Jack Soterakis, MD
Title
Vice President of Medical Affairs
Phone
(516) 562-6231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X NY Primary

Addresses

Primary practice location

2053 Bellmore Ave
Bellmore, NY 11710-5603

Mailing address

PO Box 1054
Port Washington, NY 11050-1054
Phone (516) 629-2081

Other names 1

  • Bellmore Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040708000027 NY Part B Supplier - Clinic/Group Practice 7618955667 Receives reassigned benefits from 1,098 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory

Locations

79 Deer Park Ave
Babylon, NY 11702
Phone (631) 587-0574

2053 Bellmore Ave
Bellmore, NY 11710
Phone (516) 481-6200

2200 Northern Blvd
Ste 115
Greenvale, NY 11548
Phone (516) 325-7310

1743 N Ocean Ave
Medford, NY 11763
Phone (516) 758-3100

200 Belle Terre Rd
Ste E140
Prt Jefferson, NY 11777
Phone (631) 474-6049

317 E Middle Country Rd
Ste 1
Smithtown, NY 11787
Phone (631) 360-0303

48 Route 25A
Ste 303
Smithtown, NY 11787
Phone (631) 382-4833

2500 Nesconset Hwy
Bldg 7D
Stony Brook, NY 11790
Phone (631) 751-3322

Practitioners & affiliated clinicians

Practitioners 207

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 207

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1720334527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1054",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501054",
            "telephone_number": "516-629-2081",
            "fax_number": "516-629-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2053 BELLMORE AVE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105603",
            "telephone_number": "516-679-3627",
            "fax_number": "516-679-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS PHYSICIAN PARTNERS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHS PHYSICIAN PARTNERS, PC",
        "enumeration_date": "2012-07-30",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "SOTERAKIS",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "VICE PRESIDENT OF MEDICAL AFFAIRS",
        "authorized_official_telephone_number": "516-562-6231",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellmore Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bellmore Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.