NPIMap

Organization Active NPI

Good Samaritan Hospital Medical Center

  • Neonatal-Perinatal Medicine Physician
  • West Islip, NY
National Provider Identifier
1851663140
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
5154001H Issued in NY
Legal business name
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
Practice address
1000 Montauk Hwy
Attn: Finance
West Islip, NY 11795-4927
Phone
(631) 376-3000
NPI assigned
Feb 1, 2012
Last updated
Nov 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Authorized official

Name
Jacqueline Brathwaite
Title
Dir. Physician Credentials
Phone
(516) 705-1353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080N0001X 5154001H NY Primary

Addresses

Primary practice location

1000 Montauk Hwy
Attn: Finance
West Islip, NY 11795-4927

Mailing address

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-3000

National Provider Directory

National Provider Directory
Tax ID family
Pathology Network Or Li12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

1000 Montauk Hwy
Fl 1
West Islip, NY 11795

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572825600000",
    "number": "1851663140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "address_2": "ATTN: FINANCE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2019-11-04",
        "status": "A",
        "authorized_official_last_name": "BRATHWAITE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "DIR. PHYSICIAN CREDENTIALS",
        "authorized_official_telephone_number": "516-705-1353"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "5154001H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.