NPIMap

Organization Active NPI

CHS Physician Partners, PC

Doing business as Cardiac Interventional Group

  • Interventional Cardiology Physician
  • Roslyn, NY
National Provider Identifier
1881825701
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
107338 Issued in NY
Legal business name
CHS PHYSICIAN PARTNERS, PC
Doing business as
Cardiac Interventional Group
Practice address
100 Port Washington Blvd
Suite 105
Roslyn, NY 11576-1353
Phone
(516) 390-9640
Fax
(516) 390-9650
NPI assigned
Jul 28, 2009
Last updated
Jul 19, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
CHS PHYSICIAN PARTNERS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Authorized official

Name
Jack Soterakis, M.D.NPI 1598768624
Title
President
Phone
(516) 562-6231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 107338 NY Primary

Addresses

Primary practice location

100 Port Washington Blvd
Suite 105
Roslyn, NY 11576-1353

Mailing address

PO Box 1054
Port Washington, NY 11050-1054
Phone (516) 629-2477

Other names 1

  • Cardiac Interventional Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040708000027 NY Part B Supplier - Clinic/Group Practice 7618955667 Receives reassigned benefits from 1,098 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Part of
CHS Physician Partners PC

Locations

116 Terryville Rd
Port Jefferson Station, NY 11776
Phone (631) 928-2002

111 Beach Dr
West Islip, NY 11795
Phone (631) 587-1600

Practitioners & affiliated clinicians

Practitioners 202

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.

View all 202

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1881825701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1054",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501054",
            "telephone_number": "516-629-2477",
            "fax_number": "516-629-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "address_2": "SUITE 105",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-390-9640",
            "fax_number": "516-390-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS PHYSICIAN PARTNERS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHS PHYSICIAN PARTNERS, PC",
        "enumeration_date": "2009-07-28",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "SOTERAKIS",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-562-6231",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "107338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiac Interventional Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cardiac Interventional Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roslyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.

Verify at the official NPI Registry.