COSMETIC SURGERY OF NEW YORK PC
NPI 1124229562
Specialist in Port Jefferson Station, NY

NPI Status: Active since May 31, 2007

Contact Information

4616 NESCONSET HWY
PORT JEFFERSON STATION, NY
ZIP 11776
Phone: (631) 473-7070
Fax: (631) 331-2654

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  • Organization
  • Specialist
  • CLIA Number: 33D2225039
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-26-2027

About COSMETIC SURGERY OF NEW YORK PC

This page provides the complete NPI Profile along with additional information for Cosmetic Surgery Of New York Pc, a provider established in Port Jefferson Station, New York operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1124229562 assigned on May 2007. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Robert Alan Jacobs M.d. (Surgeon)

NPI
1124229562
Provider Name
COSMETIC SURGERY OF NEW YORK PC
Entity Type
Organization
Location Address
4616 NESCONSET HWY PORT JEFFERSON STATION, NY 11776
Location Phone
(631) 473-7070
Location Fax
(631) 331-2654
Mailing Address
4616 NESCONSET HWY PORT JEFFERSON STATION, NY 11776
Mailing Phone
(631) 473-7070
Mailing Fax
(631) 331-2654
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-31-2007
Last Update Date
07-21-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License State
NY
Taxonomy Description
An 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.

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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. ROBERT ALAN JACOBS M.D.

Authorized Official Title
SURGEON
Authorized Official Phone
(631) 473-7070

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
A400036602OTHER (01)NYPTAN

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 this NPI number is:

CLIA Number
33D2225039
Facility Type
Physician Office
Certificate Effective Date
May 18, 2021
Certificate Expiration Date
March 26, 2027
Laboratory Director
DR. ROBERT A. JACOBS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Cosmetic Surgery Of New York Pc 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.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1124229562, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
2
Doubled → 4
Pos 4
4
Unchanged
Pos 5
2
Doubled → 4
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
5
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 2 → 4 9 → 18 → 9 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 4 + 4 + 4 + 2 + 1 + 8 + 5 + 1 + 2 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1124229562.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Specialist
4616 NESCONSET HWY
PORT JEFFERSON STATION, NY 11776
Specialist
4616 NESCONSET HWY
PORT JEFFERSON STATION, NY 11776
Specialist
4616 NESCONSET HWY
PORT JEFFERSON STATION, NY 11776

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124229562, enumerated as an "organization" on May 31, 2007.

The provider is located at 4616 NESCONSET HWY PORT JEFFERSON STATION, NY 11776 and the phone number is (631) 473-7070.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.