CHANAK CHANTACHOTE (NPI# 1093004384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093004384 |
| Entity Type | Individual |
| Full Name | CHANAK CHANTACHOTE |
| Credential | M.D. |
| Practice Address |
Department of Surgery 79 Middleville Rd Northport NY 11725 |
| Practice Telephone | 6312614400 |
| Mailing Telephone | 6312614400 |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2020-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
A143223 | CA | Allopathic & Osteopathic Physicians |
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
A143223 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
DEPARTMENT OF SURGERY 79 MIDDLEVILLE RD |
| City | NORTHPORT |
| State | NY |
| Zip Code | 11725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699322131 | Amanda Grace Acebedo | Student in an Organized Health Care Education/Training Program | 785 Larkfield Rd, Commack, NY 11725 | 2019-08-20 |
| 1922667716 | Diana Mcnamara | Social Worker | 13 Audrey Lane, Commack, NY 11725 | 2019-06-06 |
| 1821504333 | Amy Koenig | Specialist | 787 Larkfield Rd, Commack, NY 11725 | 2017-12-19 |
| 1437661501 | Commack Chemist Inc | Pharmacy | 6216 Jericho Turnpike, Commack, NY 11725 | 2017-10-30 |
| 1285168880 | Stephanie Arico | Counselor | 14 Silver Pond Cir, Commack, NY 11725 | 2017-04-20 |
| 1235684432 | Ams Primary Medical Care House Calls,pc | Home Health | 6277 Jericho Tpk, Commack, NY 11725 | 2016-08-18 |
| 1376927459 | Min Sun Park | Dentist | All About Smiles Pediatric Dentistry, 5036 Jericho Turnpike Suite #307, Commack, NY 11725 | 2015-07-17 |
| 1467843748 | Joanna Keegan | Pharmacy Technician | 98 Veterans Memorial Highway, Commack, NY 11725 | 2015-02-09 |
| 1275936841 | Jennie Bernstein | Social Worker | 368 Veterans Hwy Ste 2, Commack, NY 11725 | 2014-09-26 |
| 1417362021 | Diana Matira Yildirim | Pediatrics | 646 Commack Road, Commack, NY 11725 | 2014-06-23 |
| Find all providers in zip 11725 | ||||
| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619442258 | Northern Westchester Surgical PC | Surgery | 672 Stoneleigh Ave Ste C116, Carmel, NY 10512-4635 | 2018-10-10 |
| 1902248248 | Stanley Wesotski | Surgery | 28 Whitney Gate, Smithtown, NY 11787-1747 | 2013-07-29 |
| 1942596762 | Isadora C Botwinick | Surgery | Hsc Level 19 Room 068, Stony Brook, NY 11794 | 2011-06-20 |
| 1912296195 | Elizabeth Kiselak | Surgery | 5 Summit Ave., Suite 105, Hackensack, NY 07601 | 2011-03-29 |
| 1144546995 | Michael Antonio Vella | Surgery | 601 Elmwood Avenue Box Surg, Rochester, NY 14642-0001 | 2010-04-19 |
| 1952539967 | Amie L Lucia | Surgery | 750 East Adams St Ste. 4835, Syracuse, NY 13210 | 2009-06-29 |
| 1083853428 | Molly Elizabeth Moore | Surgery | 205 Hammocks Dr, Orchard Park, NY 14127-1683 | 2009-02-09 |
| 1356587653 | Andrew Joseph Deroo | Surgery | 43 New Scotlland Dr, Mc-194, Albany, NY 12208 | 2008-12-17 |
| 1831367929 | Fausto Y Vinces Do Pllc | Surgery | 136 Fieldpoint Dr, Irvington, NY 10533-1858 | 2008-02-12 |
| 1104027366 | Sofia Yusuf Naz | Surgery | 199 Underhill St, Yonkers, NY 10710-3810 | 2007-05-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.