Organization Active NPI

Jason Halegoua, M.D., P.C.

  • Pediatrics Physician
  • Stony Brook, NY
National Provider Identifier
1750619581
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
231789 Issued in NY
Legal business name
JASON HALEGOUA, M.D., P.C.
Practice address
207 Hallock Rd Ste 106
Stony Brook, NY 11790-3075
Phone
(631) 675-9777
Fax
(631) 675-9778
NPI assigned
Dec 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Dr. Jason Halegoua, PHD, MD, MBANPI 1013023555
Title
President
Phone
(516) 650-3636

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 231789 NY Primary

Addresses

Primary practice location

207 Hallock Rd Ste 106
Stony Brook, NY 11790-3075

Mailing address

11 Lily Dr
South Setauket, NY 11720-2001
Phone (516) 650-3636

Other names 1

  • PEDS FIRST PEDIATRICS Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2301225Jason Halegoua207 Hallock Road, Suite 106, Stony Brook, NY 11790Certificate of waiverMar 21, 2028

National Provider Directory

National Provider Directory

Locations

207 Hallock Rd
Ste 106
Stony Brook, NY 11790
Phone (631) 675-9777

Practitioners & affiliated clinicians

Practitioners 2

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": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1750619581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LILY DR",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117202001",
            "telephone_number": "516-650-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HALLOCK RD STE 106",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903075",
            "telephone_number": "631-675-9777",
            "fax_number": "631-675-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON HALEGOUA, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2025-09-02",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "HALEGOUA",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-650-3636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, MD, MBA"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "231789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEDS FIRST PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.