Northport VA Medical Center

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

221381 Issued in NY

Legal business name

NORTHPORT VA MEDICAL CENTER

Practice address

79 Middleville Rd
Northport, NY 11768-2200

Phone

(631) 261-4400

Fax

(631) 266-6054

NPI assigned

Mar 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mandar Tank, M.D.

Title

Acos/Director

Phone

(631) 261-4400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1740249556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400",
            "fax_number": "631-266-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400",
            "fax_number": "631-266-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPORT VA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TANK",
        "authorized_official_first_name": "MANDAR",
        "authorized_official_title_or_position": "ACOS/DIRECTOR",
        "authorized_official_telephone_number": "631-261-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "221381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northport Family Medicine P.C
• Northport Optical Center Inc.
• Northport Physical Therapy P C
• Northport Podiatry PC
• Northport VA
• Northport Vamc
• Northport Vamc
• Northport Vamc
• Northport Vamc
• Northport Vamc

• General Acute Care Hospital in Northport, NY
• Providers in Northport, NY by specialty
• General Acute Care Hospital in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.