NPIMap

Organization Active NPI

Brookhaven Surgical Services, P.C.

Doing business as Brookhaven Bariatric and Wellness Program

  • Surgery Physician
  • Patchogue, NY
National Provider Identifier
1740514389
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BROOKHAVEN SURGICAL SERVICES, P.C.
Doing business as
Brookhaven Bariatric and Wellness Program
Practice address
55 Medford Ave
Suite D
Patchogue, NY 11772-1229
Phone
(631) 687-5400
Fax
(631) 687-5430
NPI assigned
Sep 30, 2009
Last updated
Sep 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Authorized official

Name
Mr. Craig Ordway, MD
Title
Owner
Phone
(631) 687-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

55 Medford Ave
Suite D
Patchogue, NY 11772-1229

Mailing address

55 Medford Ave
Suite D
Patchogue, NY 11772-1229
Phone (631) 687-5400

Other names 1

  • Brookhaven Bariatric and Wellness Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brookhaven Bariatric and Wellness Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1740514389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MEDFORD AVE",
            "address_2": "SUITE D",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721229",
            "telephone_number": "631-687-5400",
            "fax_number": "631-687-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MEDFORD AVE",
            "address_2": "SUITE D",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721229",
            "telephone_number": "631-687-5400",
            "fax_number": "631-687-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN SURGICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "ORDWAY",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-687-5400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookhaven Bariatric and Wellness Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.