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NORTHEASTERN THORACIC SURGERY, PLLC
NPI 1558054759
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Port Jefferson Station, NY

Active since June 01, 2023
1500 ROUTE 112 STE B, PORT JEFFERSON STATION, NY 11776(631) 353-0909 Get Directions Write a Review

NPPES record last updated: June 1, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Northeastern Thoracic Surgery, Pllc NPPES

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

NORTHEASTERN THORACIC SURGERY, PLLC (NPI 1558054759) is a healthcare organization registered as a thoracic surgery (cardiothoracic vascular surgery) in Port Jefferson Station, New York and active in the NPI registry since June 2023. The organization lists Gregory Brevetti, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1558054759
Entity TypeOrganization
Primary Taxonomy208G00000X
Legal Business NameNORTHEASTERN THORACIC SURGERY, PLLC
Location Address1500 ROUTE 112 STE BPort Jefferson Station, NY 11776-8055
Mailing Address1500 Route 112 Ste BPort Jefferson Station, NY 11776-8055
Phone(631) 353-0909
Organization SubpartNo
Authorized OfficialGregory BrevettiOwner/provider · (917) 575-8907
Enumeration DateJune 1, 2023
NPPES CertifiedJune 1, 2023
✔ NPI 1558054759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
1500 ROUTE 112 STE B, Port Jefferson Station, NY 11776
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 13

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

ANISH DESAI MD
Internal Medicine (Pulmonary Disease)
1500 ROUTE 112 STE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 978-7633
PETER OTTAVIO D.O.
Internal Medicine (Pulmonary Disease)
1500 ROUTE 112 STE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 978-7633
DR. KEITH WEBB HARRIS II DO
Internal Medicine (Pulmonary Disease)
1500 ROUTE 112 STE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 978-7633
DR. FRANCIS T. D'ORAZI III D.O.
Internal Medicine (Pulmonary Disease)
1500 ROUTE 112 STE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 978-7633
ISLANDWIDE THORACIC SURGERY, PLLC
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1500 ROUTE 112 STE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 353-0909
YUVAL HILTZIK D.O.
Internal Medicine (Pulmonary Disease)
1500 ROUTE 112 STE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 978-7633
DR. ANTHONY C THEODORIS M.D.
Internal Medicine (Pulmonary Disease)
1500 ROUTE 112 STE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 978-7633
SHORE TO SHORE MEDICAL WELLNESS PLLC
Specialist
1500 ROUTE 112 STE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 343-4184

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 Northeastern Thoracic Surgery, PLLC's NPI number?

The NPI number for Northeastern Thoracic Surgery, PLLC is 1558054759. It was assigned to this organization in the NPPES registry on June 1, 2023.

Where is Northeastern Thoracic Surgery, PLLC located?

Northeastern Thoracic Surgery, PLLC is located at 1500 Route 112 Ste B, Port Jefferson Station, NY 11776. The listed phone number is (631) 353-0909.

What is Northeastern Thoracic Surgery, PLLC's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

When was this NPI record last updated?

The NPPES record for Northeastern Thoracic Surgery, PLLC was last updated on June 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.