JOHN T MATHER MEMORIAL HOSPITAL (NPI# 1366816894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366816894 |
| Entity Type | Organization |
| Organization Name | JOHN T MATHER MEMORIAL HOSPITAL |
| Other Organization Name | BARIATRIC GROUP |
| Practice Address |
75 N Country Rd Suite 201 Port Jefferson NY 11777-2119 |
| Mailing Address |
100 Highlands Blvd Box 9 Port Jefferson NY 11777-2320 |
| Practice Telephone | 6316890220 |
| Practice Fax Number | 6314173042 |
| Mailing Telephone | 6316867809 |
| Mailing Fax Number | 6316867972 |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2016-04-08 |
| Authorized Official Name | JOSEPH WISNOSKI (VP FINANCE) |
| Authorized Official Telephone | 6314731320 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RB0002X |
Internal Medicine Specialization: Obesity Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Bariatric Group | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750740437 | John T Mather Memorial Hospital | General Acute Care Hospital | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2016-02-23 |
| 1922486182 | John T Mather Memorial Hospital | Physical Medicine & Rehabilitation | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2015-05-08 |
| 1881082691 | John T Mather Memorial Hospital | General Acute Care Hospital | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2014-12-31 |
| 1417355587 | John T Mather Memorial Hospital | Physical Therapist | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2014-12-05 |
| 1265844716 | John T Mather Memorial Hospital | Physician Assistant | 625 Belle Terre Rd, Suite 203, Port Jefferson, NY 11777-2316 | 2014-06-02 |
| 1427280353 | John T Mather Memorial Hospital | Surgery | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2009-08-11 |
| 1821244757 | John T Mather Memorial Hospital | General Acute Care Hospital | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2008-08-12 |
| Street Address |
75 N COUNTRY RD SUITE 201 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 11777 | ||||
| Taxonomy Code | 207RB0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Obesity Medicine |
| A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity. |
| Notes: Source: American Board of Obesity Medicine, www.abom.org [7/1/2015: title and definition modified] Additional Resource: American Society of Bariatric Physicians, www.asbp.org. |
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|---|---|---|---|---|
| 1841635547 | Verbukh Medical Group | Internal Medicine | 1575 East 19st, 4th Floor, Brooklyn, NY 11230 | 2013-05-08 |
| 1891060984 | Long Island Weight Loss Institute | Internal Medicine | 467 Old Country Rd, Westbury, NY 11590-5136 | 2012-03-21 |
| 1346774122 | Setauket Medical, PC | Internal Medicine | 4 Technology Dr, Suite 220, East Setauket, NY 11733-4080 | 2017-04-18 |
| 1174940696 | Medical Weight Loss of New York, Pllc | Internal Medicine | 6800 E Genesee St, Suite 1501, Fayetteville, NY 13066-1089 | 2014-03-21 |
| 1508127531 | Mount Sinai School of Medicine | Internal Medicine | 1 Healthy Way, Oceanside, NY 11572-1551 | 2012-06-06 |
| 1821362377 | Community Care Physicians, PC | Internal Medicine | 713 Troy Schenectady Rd, Suite 215, Latham, NY 12110-2490 | 2012-03-01 |
| 1326316209 | Carthage Area Hospital | Internal Medicine | 117 N Mechanic St, Carthage, NY 13619-1252 | 2011-12-07 |
| 1093956682 | William A Graber Md PC | Internal Medicine | 125 Business Park Dr Ste 150, Utica, NY 13502-6316 | 2009-03-12 |
| 1275784639 | Gal Gazit | Internal Medicine | 9229 Queens Blvd, Suite # Cu-6, Rego Park, NY 11374-1056 | 2008-10-03 |
| 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.