BV PORT JEFFERSON OPERATOR, LLC
NPI 1649931254
Assisted Living Facility in Port Jefferson Station, NY

Q: What is Bv Port Jefferson Operator, LLC's NPI number?

The NPI number for Bv Port Jefferson Operator, LLC is 1649931254. It was assigned to this organization in the NPPES registry on January 5, 2022. The provider is doing business as Brightview Port Jefferson.

Q: What is Bv Port Jefferson Operator, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since January 05, 2022CLIA 33D2325036 · Waiver

1175 ROUTE 112, PORT JEFFERSON STATION, NY 11776(631) 802-5021(631) 802-5022 Get Directions Write a Review

NPPES record last updated: January 5, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Bv Port Jefferson Operator, Llc NPPES

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

BV PORT JEFFERSON OPERATOR, LLC (NPI 1649931254), doing business as Brightview Port Jefferson, is a healthcare organization registered as an assisted living facility in Port Jefferson Station, New York and active in the NPI registry since January 2022. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Marilynn Duker, President / Duker, as its authorized official.

NPPES Registry Identity

NPI1649931254

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameBV PORT JEFFERSON OPERATOR, LLC

Location Address1175 ROUTE 112Port Jefferson Station, NY 11776

Mailing Address1175 Route 112Port Jefferson Station, NY 11776 · (631) 802-5021 · Fax (631) 802-5022

Phone(631) 802-5021

Fax(631) 802-5022

Organization SubpartNo

Authorized OfficialMarilynn DukerPresident / Duker · (410) 962-0595

Enumeration DateJanuary 5, 2022

NPPES CertifiedJanuary 5, 2022

✔ NPI 1649931254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X

1175 ROUTE 112, Port Jefferson Station, NY 11776

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Other Names 1

Doing Business AsBrightview Port Jefferson

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 33D2325036

Bv Port Jefferson Operator LLC · Port Jefferson Station, NY

Active · expires Mar 26, 2027

CLIA Number33D2325036

Laboratory TypeAssisted Living Facility

Certificate Effective DateJune 5, 2025

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Azmat A. Iqbal

Laboratory Phone(631) 802-5021

Laboratory LocationBv Port Jefferson Operator LLC1175 Rte 112, Port Jefferson Station, NY 11776

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

BIANCA KARWOWSKI MA, CCC-SLP

Speech-Language Pathologist

1175 ROUTE 112
PORT JEFFERSON STATION, NY 11776

Suffolk County (631) 562-5272

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 Bv Port Jefferson Operator, LLC's NPI number?

The NPI number for Bv Port Jefferson Operator, LLC is 1649931254. It was assigned to this organization in the NPPES registry on January 5, 2022. The provider is doing business as Brightview Port Jefferson.

Where is Bv Port Jefferson Operator, LLC located?

Bv Port Jefferson Operator, LLC is located at 1175 Route 112, Port Jefferson Station, NY 11776. The listed phone number is (631) 802-5021.

What is Bv Port Jefferson Operator, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Bv Port Jefferson Operator, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2325036) is associated with this NPI, valid through March 26, 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 Bv Port Jefferson Operator, LLC was last updated on January 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.