Premier Surgical PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

221334-1 Issued in NY

Legal business name

PREMIER SURGICAL PLLC

Practice address

285 Sills Rd
BLDG 3 Suite 2a
Patchogue, NY 11772

Phone

(631) 207-2807

Fax

(631) 207-5077

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Danielle C Clarke, M.A.

Title

Medical Assistant

Phone

(631) 207-2807

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/40521fdf-a90b-4eb2-b8bc-77e90b0288d6/

Practitioners 2

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.

• Ravindra Kota, M.D.

  • Surgery Physician
  • East Patchogue, NY
  • NPI 1780651323
  Medicare reassignment NPD
• Anjani Kota, M.D.

  • Internal Medicine Physician
  • East Setauket, NY
  • NPI 1720055353
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1740349927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BRAYTON CT N",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117204625",
            "telephone_number": "631-475-6663",
            "fax_number": "631-475-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BLDG 3 SUITE 2A",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-207-2807",
            "fax_number": "631-207-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SURGICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL ASSISTANT",
        "authorized_official_telephone_number": "631-207-2807",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "221334-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Cronan Power, PT, DPT
• Powerful Physical Therapy, PLLC
• Kaitlin Nicole Pranav, M.A., CCC-SLP, TSSLD
• Premier Endodontics of Patchogue
• Premier Physical Therapy of Long Island PC
• Primecare Essentials Inc
• Skyler Rae Princi, PA
• Elisa S Procaccini, MSPT
• Progressive Orthotics LTD
• Margherita N Proscia

• Surgery Physician in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.