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PATCHOGUE PEDIATRICS PC
NPI 1396178000
Pediatrics in East Patchogue, NY

Active since August 16, 2013CLIA 33D2066029 · Waiver
264 SILLS RD, EAST PATCHOGUE, NY 11772(631) 504-6261(631) 504-6263 Get Directions Write a Review

NPPES record last updated: August 16, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Patchogue Pediatrics Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PATCHOGUE PEDIATRICS PC (NPI 1396178000) is a healthcare organization registered as a pediatrics in East Patchogue, New York and active in the NPI registry since August 2013. The organization holds a CLIA Waiver certificate valid through September 18, 2027 and lists Audrey A Chong-gayle, President, as its authorized official.

NPPES Registry Identity

NPI1396178000
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePATCHOGUE PEDIATRICS PC
Location Address264 SILLS RDEast Patchogue, NY 11772-8804
Mailing Address264 Sills RdEast Patchogue, NY 11772-8804 · (631) 504-6261 · Fax (631) 504-6263
Phone(631) 504-6261
Fax(631) 504-6263
Organization SubpartNo
Authorized OfficialAudrey A Chong-gaylePresident · (631) 504-6261
Enumeration DateAugust 16, 2013
✔ NPI 1396178000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
264 SILLS RD, East Patchogue, NY 11772
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Other Identifiers 1

Medicaid02022351NY

Group Practice 1

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2066029

Patchogue Pediatrics PC · East Patchogue, NY
Active · expires Sep 18, 2027
CLIA Number33D2066029
Laboratory TypePhysician Office
Certificate Effective DateSeptember 19, 2025
Certificate Expiration DateSeptember 18, 2027
Laboratory DirectorDr. Audrey A. Chong-Gayle
Laboratory Phone(631) 504-6261
Laboratory LocationPatchogue Pediatrics PC264 Sills Road, East Patchogue, NY 11772
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. DANA ANNE VECCHIO NP
Nurse Practitioner
264 SILLS RD
EAST PATCHOGUE, NY 11772
Suffolk County (631) 504-6261
ERICA ERCOLANI PA
Physician Assistant
264 SILLS RD
EAST PATCHOGUE, NY 11772
Suffolk County (631) 504-6261

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Patchogue Pediatrics PC's NPI number?

The NPI number for Patchogue Pediatrics PC is 1396178000. It was assigned to this organization in the NPPES registry on August 16, 2013.

Where is Patchogue Pediatrics PC located?

Patchogue Pediatrics PC is located at 264 Sills Rd, East Patchogue, NY 11772. The listed phone number is (631) 504-6261.

What is Patchogue Pediatrics PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Patchogue Pediatrics PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2066029) is associated with this NPI, valid through September 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Patchogue Pediatrics PC was last updated on August 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.