Active NPI
Long Island Surgery P.C.
- Surgery Physician
- Patchogue, NY
National Provider Identifier
1790716546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 194796
- Legal business name
- LONG ISLAND SURGERY P.C.
- Practice address
- 4 Phyllis Drive
Patchogue, NY 11772 - Phone
- (631) 289-4700
- Fax
- (631) 289-4718
- NPI assigned
- Jul 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Badri P Nath, MD
- Title
- MD
- Phone
- (631) 289-4700
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 194796 | NY | Primary |
Addresses
Primary practice location
4 Phyllis Drive
Patchogue, NY 11772
Mailing address
4 Phyllis Drive
Patchogue, NY 11772
Phone (631) 289-4700
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P773785 | Other | NY | OXF |
| 01762005 | Medicaid | NY | |
| 5020361 | Other | NY | SUFFOLK HEALTHPLAN |
| 020038452 | Other | NY | MCR RR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060421000490 | NY | Part B Supplier - Clinic/Group Practice | 6901816842 |
Receives reassigned benefits from 9 practitioners Practice locations: Patchogue, NY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgical Critical Care Physician
- Patchogue, NY
- NPI 1689852386
NY, Surgical Critical Care
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1393372800000",
"number": "1790716546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 PHYLLIS DRIVE",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "11772",
"telephone_number": "631-289-4700",
"fax_number": "631-289-4718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 PHYLLIS DRIVE",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "11772",
"telephone_number": "631-289-4700",
"fax_number": "631-289-4718"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONG ISLAND SURGERY P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-06",
"last_updated": "2014-02-26",
"status": "A",
"authorized_official_last_name": "NATH",
"authorized_official_first_name": "BADRI",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "631-289-4700",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": "NY",
"license": "194796",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXF",
"identifier": "P773785",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01762005",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUFFOLK HEALTHPLAN",
"identifier": "5020361",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCR RR",
"identifier": "020038452",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}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 Feb 26, 2014; 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.