JOHN T. MATHER MEMORIAL HOSPITAL (NPI# 1285920231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285920231 |
| Entity Type | Organization |
| Organization Name | JOHN T. MATHER MEMORIAL HOSPITAL |
| Practice Address |
75 N Country Rd Port Jefferson NY 11777-2119 |
| Mailing Address |
625 Belle Terre Rd Suite100 Port Jefferson NY 11777-2316 |
| Practice Telephone | 6314731320 |
| Mailing Telephone | 6316867689 |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-06-28 |
| Authorized Official Name | MR. JOSEPH WISNOSKI (CFO) |
| Authorized Official Telephone | 6314731320 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718728 | John T. Mather Memorial Hospital | Psychiatric Unit | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2005-05-27 |
| 1629456595 | John T. Mather Memorial Hospital | Local Education Agency (LEA) | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2015-05-12 |
| 1639585706 | John T. Mather Memorial Hospital | Clinic/Center | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2014-07-09 |
| 1073863635 | John T. Mather Memorial Hospital | Family Medicine | 75 North Country Rd, Port Jefferson, NY 11777-2190 | 2012-09-11 |
| 1336428796 | John T. Mather Memorial Hospital | Radiology | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2011-08-16 |
| 1568774453 | John T. Mather Memorial Hospital | Psychiatry & Neurology | 5505 Nesconset Hwy, Mount Sinai, NY 11766-2037 | 2010-07-08 |
| 1891816070 | John T. Mather Memorial Hospital | Radiology | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2007-04-03 |
| 1568590115 | John T. Mather Memorial Hospital | General Acute Care Hospital | 120 N Country Rd, Port Jefferson, NY 11777-2604 | 2007-03-02 |
| 1396834750 | John T. Mather Memorial Hospital | Nurse Practitioner | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2006-10-12 |
| 1417044066 | John T. Mather Memorial Hospital | Nurse Practitioner | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2006-10-06 |
| Street Address |
75 N COUNTRY RD |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718728 | John T. Mather Memorial Hospital | Psychiatric Unit | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2005-05-27 |
| 1124633169 | Ewelina Mieczkowska | Physician Assistant | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-09-15 |
| 1114546652 | Kelly Miller | Registered Nurse | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-14 |
| 1194344143 | John Lotfi | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-10 |
| 1669001897 | Robert Franklin Wilson | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-08 |
| 1245868611 | Tia Bimal | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-31 |
| 1427686203 | Aakash Babaria | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-29 |
| 1821626789 | Anjali Kewalramani | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-27 |
| 1578190591 | Joon Oh | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2190 | 2020-03-27 |
| 1871121848 | Sonali Nanda | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1073097531 | Ministry for Hope, Inc. Montfort Therapeutic Residence | Residential Treatment Facility, Physical Disabilities | 100 Stonyhill Road, Port Jefferson, NY 11777 | 2018-09-20 |
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| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114543287 | Todd R Waldorf Do Pllc | Neuromusculoskeletal Medicine & OMM | 555 Breed Hill Road, Crown Point, NY 12928-1731 | 2020-06-24 |
| 1174171698 | Hamptons Osteopathy P.C. | Neuromusculoskeletal Medicine & OMM | 518 Montauk Hwy # 101b, Amagansett, NY 11930-2110 | 2019-08-28 |
| 1912560210 | Mehar Ghei | Neuromusculoskeletal Medicine & OMM | St. Barnabas Hospital 4487 3rd Ave, The Bronx, NY 10457 | 2019-04-22 |
| 1811474745 | Charles B Schaap Jr. | Neuromusculoskeletal Medicine & OMM | 12 Montesi Dr, Highland Mills, NY 10930-3048 | 2018-07-24 |
| 1205377082 | Hebatallah Rashed | Neuromusculoskeletal Medicine & OMM | 450e, 63rd Street, 9b, New York, NY 10065 | 2017-03-14 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1821402074 | Bethany Prater | Neuromusculoskeletal Medicine & OMM | 32 W 96th St Apt A, New York, NY 10025 | 2014-06-16 |
| 1255743027 | Jacob Joseph Cukierski | Neuromusculoskeletal Medicine & OMM | 8604 Main St Ste 4, Williamsville, NY 14221-7463 | 2014-05-28 |
| 1083032916 | Ny Pain Practice LLC | Neuromusculoskeletal Medicine & OMM | 4287 Katonah Ave, Bronx, NY 10470-2122 | 2014-03-28 |
| 1316377260 | Empire Osteopathy LLC | Neuromusculoskeletal Medicine & OMM | 332a Canoe Place Road, Southampton, NY 11968 | 2013-11-13 |
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| City | PORT JEFFERSON |
| Zip Code | 11777 |
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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.