NPIMap

Organization Active NPI

Memorial Sloan Kettering Cancer Center

Doing business as Memorial Sloan Kettering at Commack Retail

  • Community/Retail Pharmacy
  • Commack, NY
National Provider Identifier
1831601772
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
025357 Issued in NY
Legal business name
MEMORIAL SLOAN KETTERING CANCER CENTER
Doing business as
Memorial Sloan Kettering at Commack Retail
Practice address
650 Commack Rd Ste 1401
Commack, NY 11725-5404
Phone
(631) 212-6110
NPI assigned
Nov 1, 2017
Last updated
Mar 19, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Susan Murillo
Title
Pharmacy Manager
Phone
(212) 639-2206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 025357 NY Primary

Addresses

Primary practice location

650 Commack Rd Ste 1401
Commack, NY 11725-5404

Mailing address

1275 York Ave RM H-313
New York, NY 10065-6007
Phone (212) 639-2206

Other names 1

  • Memorial Sloan Kettering at Commack Retail Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190918002833 NY DME Supplier - Pharmacy 9931304375 Practice locations: Commack, NY
O20220502000985 NY Part B Supplier - Pharmacy 9931304375 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Commack, NY; Long Island City, NY; New York, NY; West Harrison, NY

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Memorial Sloan Kettering at Commack650 Commack Rd, Commack, NY 11725-5404(631) 212-6110 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jun 1, 1999

National Provider Directory

National Provider Directory
Tax ID family
Mskcc21 organizations share this tax ID, including this one
Part of
Mskcc

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1831601772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE RM H-313",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 COMMACK RD STE 1401",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255404",
            "telephone_number": "631-212-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL SLOAN KETTERING CANCER CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES",
        "enumeration_date": "2017-11-01",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "MURILLO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "212-639-2206"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "025357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Sloan Kettering at Commack Retail",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.