Organization Active NPI

Winthrop Community Medical Affiliates, PC

Doing business as Greenport Primary Medical Care

  • Internal Medicine Physician
  • Greenport, NY
National Provider Identifier
1932564630
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WINTHROP COMMUNITY MEDICAL AFFILIATES, PC
Doing business as
Greenport Primary Medical Care
Practice address
74825 Main Rd
Greenport, NY 11944-2823
Phone
(631) 477-7120
Fax
(631) 477-2983
NPI assigned
Dec 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Authorized official

Name
Philip Ragno, MD
Title
Co-President
Phone
(516) 877-2629

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

74825 Main Rd
Greenport, NY 11944-2823

Mailing address

700 Hicksville Rd
Suite 204
Bethpage, NY 11714-3471
Phone (516) 576-5822

Other names 1

  • Greenport Primary Medical Care Doing business as

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0160583Winthrop Community Medical Affiliates PC74825 Main Rd - Suite 2, Greenport, NY 11944Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1932564630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HICKSVILLE RD",
            "address_2": "SUITE 204",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143471",
            "telephone_number": "516-576-5822",
            "fax_number": "516-576-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74825 MAIN RD",
            "city": "GREENPORT",
            "state": "NY",
            "postal_code": "119442823",
            "telephone_number": "631-477-7120",
            "fax_number": "631-477-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINTHROP COMMUNITY MEDICAL AFFILIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "RAGNO",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "516-877-2629",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenport Primary Medical Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.