EXTENDACARE INC. (NPI# 1669692448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669692448 |
| Entity Type | Organization |
| Organization Name | EXTENDACARE INC. |
| Other Organization Name | MEDISTAF HEALTH & RESEARCH |
| Practice Address |
646 Main St Port Jefferson NY 11777-2235 |
| Practice Telephone | 6314731317 |
| Practice Fax Number | 6314731337 |
| Mailing Telephone | 6314731317 |
| Mailing Fax Number | 6314731337 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2008-10-06 |
| Authorized Official Name | MR. BRUCE A UVEGES (ADMINISTRATOR) |
| Authorized Official Telephone | 6314731317 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251F00000X | Home Infusion | 9589L001 | NY | Agencies |
| N | 251J00000X | Nursing Care | 9589L001 | NY | Agencies |
| Y | 251E00000X | Home Health | 9589L001 | NY | Agencies |
| Other Name | Type Code |
|---|---|
| Medistaf Health & Research | Doing Business As Name - Organization |
| Street Address |
646 MAIN ST |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777-2235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790325496 | Frank Farrell | Psychologist | 646 Main St, Port Jefferson, NY 11777-2235 | 2020-01-10 |
| 1952775934 | Farrell Psychological Services, Pllc | Psychologist | 646 Main St, Port Jefferson, NY 11777-2235 | 2015-11-13 |
| 1205248101 | Farrell Health Group LLC | Psychologist | 646 Main St, Port Jefferson, NY 11777-2235 | 2014-05-27 |
| 1043562986 | Hope Tms Medical Practice PC | Clinic/Center | 646 Main St, Suite 201, Port Jefferson, NY 11777-2235 | 2012-10-02 |
| 1659669208 | Laura Chan, Nurse Practitioner-psychiatry, P.C. | Nurse Practitioner | 646 Main St, Suite 201, Port Jefferson, NY 11777-2235 | 2011-07-18 |
| 1619000296 | Karen Sivin | Social Worker | 646 Main St, Port Jefferson, NY 11777-2235 | 2007-03-13 |
| 1104964410 | Robert David Polin | Social Worker | 646 Main St, Lower Level, Port Jefferson, NY 11777 | 2007-02-01 |
| 1962557629 | Jagdish Gidwani | Psychiatry & Neurology | 646 Main St, Port Jefferson, NY 11777-2235 | 2007-01-24 |
| 1700930286 | Linda Joyce Bucaria | Psychologist | 646 Main St, Port Jefferson, NY 11777 | 2007-01-22 |
| 1528119294 | Debra Joan Kingsley | Counselor | 646 Main St, Port Jefferson, NY 11777-2235 | 2007-01-16 |
| 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 | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750524070 | Critical Health Care Registered Nursing Services, PC | Home Health | 17 N Country Rd Ste B, Port Jefferson, NY 11777-2271 | 2009-04-16 |
| 1396995841 | Harley Schildkraut | Home Health | 168 Windward Ct S, Port Jefferson, NY 11777-2326 | 2008-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972024 | Consortium Home Care Inc | Home Health | 16316 Northern Blvd Fl 2, Flushing, NY 11358-2645 | 2020-11-03 |
| 1679172100 | Amelia Home Care Inc. | Home Health | 3007 Ocean Pkwy Apt 1, Brooklyn, NY 11235-8053 | 2020-10-26 |
| 1164021887 | Preferred Certified, LLC | Home Health | 5223 Broadway, Bronx, NY 10463-7636 | 2020-10-23 |
| 1063010767 | 6677 Broadway LLC | Home Health | 140 Beach 119th St, Rockaway Park, NY 11694-1953 | 2020-10-14 |
| 1730787524 | Michele L Spinnichia | Home Health | 34 Blakeslee St, Rochester, NY 14609-2212 | 2020-10-13 |
| 1497353379 | Nuimage Wellness Services Inc | Home Health | 320 Wilson St Ste 2, West Hempstead, NY 11552-2019 | 2020-10-13 |
| 1124626312 | Julienne E Corp | Home Health | 1468 E 100th St, Brooklyn, NY 11236-5521 | 2020-10-12 |
| 1821695834 | Rymax Electronics Inc | Home Health | 1805 5th Ave Ste F, Bay Shore, NY 11706-1761 | 2020-10-02 |
| 1003421074 | Massagebywen Pllc | Home Health | 24028 Memphis Ave, Rosedale, NY 11422-2017 | 2020-09-15 |
| 1679188056 | Anchor Home Care, LLC | Home Health | 50 Lakefront Boulevard Suite 200, Buffalo, NY 14202-4301 | 2020-09-11 |
| Find all providers with the same taxonomy | ||||
| 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.