SOUTHAMPTON URGENT MEDICAL CARE P C NPI 1003020017

Specialist in Southampton, NY

Organization Specialist CLIA Number 33D1011892 CLIA Certificate of Waiver

About SOUTHAMPTON URGENT MEDICAL CARE P C

Southampton Urgent Medical Care P C is a provider established in Southampton, New York specializing in Specialist. The NPI number of Southampton Urgent Medical Care P C is 1003020017 and was assigned on May 2007. The practitioner's primary taxonomy code is 174400000X with license number 181198 (NY). The provider is registered as an organization and their NPI record was last updated 9 years ago. Southampton Urgent Medical Care P C operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Mark R Kot Md (Owner Md)

The CLIA number of Southampton Urgent Medical Care P C is 33D1011892 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Southampton Urgent Medical Care P C to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003020017

Provider NameSOUTHAMPTON URGENT MEDICAL CARE P C
Provider Location Address609 HAMPTON RD SOUTHAMPTON, NY 11968
Provider Mailing Address609 HAMPTON RD SOUTHAMPTON, NY 11968
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-09-2007
Last Update Date06-03-2013


Primary Taxonomy

Taxonomy Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.181198
License StateNY
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Business Address

SOUTHAMPTON URGENT MEDICAL CARE P C
609 HAMPTON RD
SOUTHAMPTON, NY
ZIP 11968
Phone: (631) 204-9600
Fax: (631) 204-9606

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Mailing Address

SOUTHAMPTON URGENT MEDICAL CARE P C
609 HAMPTON RD
SOUTHAMPTON, NY
ZIP 11968
Phone: (631) 204-9600
Fax: (631) 204-9606


Authorized Official

Authorized Official NameDR. MARK R KOT MD
Authorized Official TitleOWNER MD
Authorized Official Phone(631) 204-9600

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003020017 is:

CLIA Number33D1011892
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
=========OTHER (01)NYTIN
F65613MEDICARE UPIN (02)NY
WEM721MEDICARE ID-TYPE UNSPECIFIED (04)NYMEDICARE GROUP

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003020017
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200302002
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 2 + 0 + 0 + 2 + 24 = 33
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 33 = 77

The NPI number 1003020017 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1295772077 MARK ROBERT KOT M.D.
Individual
General Practice609 HAMPTON RD
SOUTHAMPTON, NY 11968
(631) 204-9600

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Southampton Urgent Medical Care P C is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.