Active NPI
The Long Island Home
- Psychiatric Hospital
- Amityville, NY
National Provider Identifier
1821394016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- Legal business name
- THE LONG ISLAND HOME
- Practice address
- 400 Sunrise Hwy
Amityville, NY 11701-2508 - Phone
- (631) 264-4000
- NPI assigned
- Feb 4, 2011
- Organization subpart
- Yes
- Parent organization
- THE LONG ISLAND HOME
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Michele Cusak
- Title
- Cfo
- Phone
- (631) 608-5107
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | NY | Primary |
Addresses
Primary practice location
400 Sunrise Hwy
Amityville, NY 11701-2508
Mailing address
400 Sunrise Hwy
Amityville, NY 11701-2508
Phone (631) 264-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00274391 | Medicaid | NY |
Other names 1
- South Oaks Hospital
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110411000230 | NY | Part B Supplier - Hospital Department(S) | 8224055108 |
Receives reassigned benefits from 126 practitioners 1 other NPI on this enrollment Practice locations: Amityville, NY |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Long Island Home
Locations
400 Sunrise Hwy
Amityville, NY 11701
Phone (631) 264-4000
Practitioners & affiliated clinicians
Practitioners 133
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Brentwood, NY
- NPI 1700262854
NY
-
- Psychiatric/Mental Health Nurse Practitioner
- Amityville, NY
- NPI 1568765683
NY
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296777600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658793600000",
"number": "1821394016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 SUNRISE HWY",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117012508",
"telephone_number": "631-264-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 SUNRISE HWY",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117012508",
"telephone_number": "631-264-4000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE LONG ISLAND HOME",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "THE LONG ISLAND HOME",
"enumeration_date": "2011-02-04",
"last_updated": "2022-07-26",
"certification_date": "2022-07-26",
"status": "A",
"authorized_official_last_name": "CUSAK",
"authorized_official_first_name": "MICHELE",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "631-608-5107",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00274391",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "South Oaks Hospital",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "South Oaks Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Amityville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.