Covered Entity Details

DSH330214FY NYU Langone Hospitals (Approved) - information as of 4/23/2025 10:53:38 PM

Main Details

Name

NYU Langone Hospitals

Subdivision Name

NYU Langone Hospital - Suffolk - EKG - EKG

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH330214FY

Medicare Provider Number

330214

Outpatient Facility Provider Number

Additional Details

Current Program Status

Approved

Registration Date

4/9/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/15/2025

Last Recertification Date

Contacts

Authorizing Official

NYU Langone Health
JOSEPH LHOTA, Chief Financial Officer
(646) 634-3670

Primary Contact

NYU Langone Health
Kristopher DaCosta, Director of 340B and Pharmacy Business & Analytics
(646) 754-9356

Addresses

Street Address

101 Hospital Road
Patchogue, NY 11772

Billing Address

NYU Langone Hospitals
PO Box 427
Elmsford, NY 10523

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
NY	00244211,02996078,02998552,02999026,02999062,02999071,03000048,03000057,03000066,03179260,04785324,00245529,02999695,02999719	1801992631,1821138959,1558809756,1730695263,1659470276,1437230034,1669578324,1619341716,1427616002,1114925567,1083612089,1831197797,1760480628,1487743480,1831910355,1013724061

Shipping Addresses

Shipping Address 1

Long Island Community Hospital
101 Hospital Road
2nd Floor
Patchogue, NY 11772

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH330214A	Child	DSH	NYU Langone Hospitals	NYU Langone Levit Medical- Ambulatory Care	1220 Avenue P	Brooklyn	NY	Active
DSH330214AA	Child	DSH	NYU Langone Hospitals	NYU Langone Ambulatory Care—23rd Street	324 East 23rd Street	New York	NY	Active
DSH330214AB	Child	DSH	NYU Langone Hospitals	NYU Langone Outpatient Surgery Center	339 East 38th Street	New York	NY	Active
DSH330214AC	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Center-EMG	333 East 38th Street	New York	NY	Active
DSH330214AD	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Center-Pain Management	333 East 38th Street	New York	NY	Terminated
DSH330214AE	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Center-PT, OT, Physiatry	333 East 38th Street	New York	NY	Terminated
DSH330214AF	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Center- Radiology	333 East 38th Street	New York	NY	Active
DSH330214AG	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Center-Spine	333 East 38th Street	New York	NY	Terminated
DSH330214AH	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Center-Sports Medicine	333 East 38th Street	New York	NY	Terminated
DSH330214AJ	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Center-Infusion	333 East 38th Street	New York	NY	Active
DSH330214AK	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Center-Rheumatology	333 East 38th Street	New York	NY	Active
DSH330214AL	Child	DSH	NYU Langone Hospitals	Initiative for Women with Disabilities	318 East 23rd Street	New York	NY	Active
DSH330214AM	Child	DSH	NYU Langone Hospitals	Cardiac Catheterization Laboratory	550 First Avenue	New York	NY	Terminated
DSH330214AN	Child	DSH	NYU Langone Hospitals	Day Surgery Center	550 First Avenue	New York	NY	Terminated
DSH330214AP	Child	DSH	NYU Langone Hospitals	Preston Robert Tisch Center for Men’s Health	555 Madison Avenue	New York	NY	Active
DSH330214AQ	Child	DSH	NYU Langone Hospitals	Observation	570 First Avenue	New York	NY	Terminated
DSH330214AR	Child	DSH	NYU Langone Hospitals	Ronald O. Perelman Center for Emergency Services	570 First Avenue	New York	NY	Terminated
DSH330214AS	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Hospital - Ambulatory Center	240 East 18th Street, Suite 21	New York	NY	Terminated
DSH330214AT	Child	DSH	NYU Langone Hospitals	NYU Langone Occupational & Industrial Orthopedic Center	63 Downing Street	New York	NY	Terminated
DSH330214AU	Child	DSH	NYU Langone Hospitals	Radiology - Joseph S. & Diane H. Steinberg Ambulatory Care Center	70 Atlantic Ave	Brooklyn	NY	Active
DSH330214AV	Child	DSH	NYU Langone Hospitals	Cobble Hill Emergency Department at the Joseph S. & Diane H. Steinberg Ambulatory Care Center	70 Atlantic Ave	Brooklyn	NY	Active
DSH330214AW	Child	DSH	NYU Langone Hospitals	NYU Langone Levit Medical—Canarsie	9708 Seaview Avenue	Brooklyn	NY	Terminated
DSH330214AX	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center—Rego Park- Imaging	97-77 Queens Boulevard	Rego Park	NY	Active
DSH330214AY	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center—Rego Park-Infusion Center	97-77 Queens Boulevard	Rego Park	NY	Active
DSH330214AZ	Child	DSH	NYU Langone Hospitals	Ambulatory Care Rego Park	97-85 Queens Blvd.	Rego Park	NY	Active
DSH330214B	Child	DSH	NYU Langone Hospitals	Rusk Rehabilitation at Levit Medical—Avenue P	1300 Avenue P	Brooklyn	NY	Terminated
DSH330214BA	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Ambulance Services	150 55th St	Brooklyn	NY	Active
DSH330214BB	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Anesthesiology	150 55th St	Brooklyn	NY	Terminated
DSH330214BC	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Cardiac Catheterization Lab	150 55th St	Brooklyn	NY	Active
DSH330214BD	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Cat Scan	150 55th St	Brooklyn	NY	Active
DSH330214BE	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Brooklyn-Delivery Room & Labor Room	150 55th St	Brooklyn	NY	Active
DSH330214BF	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Electrocardiology	150 55th St	Brooklyn	NY	Active
DSH330214BG	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Electroencephalography	150 55th St	Brooklyn	NY	Active
DSH330214BH	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Brooklyn-Emergency (Non-Distinct Observation)	150 55th St	Brooklyn	NY	Active
DSH330214BJ	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Emergency Room	150 55th St	Brooklyn	NY	Active
DSH330214BK	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Endoscopy	150 55th St	Brooklyn	NY	Active
DSH330214BL	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-ER Trauma Center	150 55th St	Brooklyn	NY	Terminated
DSH330214BM	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Magnetic Resonance Imaging	150 55th St	Brooklyn	NY	Active
DSH330214BN	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Minor Procedure Room	150 55th St	Brooklyn	NY	Terminated
DSH330214BP	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center - Sunset Park	5718 Second Avenue	Brooklyn	NY	Active
DSH330214BQ	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Operating Room	150 55th St	Brooklyn	NY	Active
DSH330214BR	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Physical Therapy	150 55th St	Brooklyn	NY	Terminated
DSH330214BS	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Radioisotope	150 55th St	Brooklyn	NY	Active
DSH330214BT	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Radiology-Diagnostic	150 55th St	Brooklyn	NY	Active
DSH330214BU	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Radiology-Special Procedures	150 55th St	Brooklyn	NY	Terminated
DSH330214BV	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Radiology-Therapeutic(Radiation Oncology)	5718 Second Ave	Brooklyn	NY	Active
DSH330214BW	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Recovery Room	150 55th St	Brooklyn	NY	Terminated
DSH330214BX	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Renal Dialysis	150 55th St	Brooklyn	NY	Terminated
DSH330214BY	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Respiratory Therapy	150 55th St	Brooklyn	NY	Terminated
DSH330214BZ	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Ultrasound Diagnostic	150 55th St	Brooklyn	NY	Terminated
DSH330214C	Child	DSH	NYU Langone Hospitals	Stephen D. Hassenfeld Children’s Center for Cancer & Blood Disorders	160 East 32nd Street	New York	NY	Active
DSH330214CA	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital-Brooklyn-Vascular Lab	150 55th St	Brooklyn	NY	Active
DSH330214CB	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Hospital-Immediate Care	301 E 17th Street	New York	NY	Active
DSH330214CC	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Hospital-Neuro Rehab	301 E 17th Street	New York	NY	Active
DSH330214CD	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Hospital-Center for Children	301 E 17th Street	New York	NY	Active
DSH330214CE	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Hospital - Peri-Op	301 E 17th Street	New York	NY	Active
DSH330214CF	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Hospital-Radiology	301 E 17th Street	New York	NY	Active
DSH330214CG	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center-34th Street- Speech & Swallow	160 East 34th Street	New York	NY	Terminated
DSH330214CH	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center-34th Street- Integrated Medicine	160 East 34th Street	New York	NY	Active
DSH330214CJ	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center-34th Street- ENT	160 East 34th Street	New York	NY	Active
DSH330214CK	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center-34th Street- Pulmonology	160 East 34th Street	New York	NY	Active
DSH330214CL	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center-34th Street- Psych	160 East 34th Street	New York	NY	Terminated
DSH330214CM	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center-34th Street- Ortho	160 East 34th Street	New York	NY	Active
DSH330214CN	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center-38th Street- Gastroenterology	240 East 38th Street, New York, NY 10016	New York	NY	Active
DSH330214CP	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island LVAD Transplant	222 Station Plaza	Mineola	NY	Active
DSH330214CQ	Child	DSH	NYU Langone Hospitals	NYU Langone Orthopedic Hospital Primary Care Center	318 East 23rd Street	New York	NY	Active
DSH330214CR	Child	DSH	NYU Langone Hospitals	Tisch Peri-Op	550 1st Avenue	New York	NY	Terminated
DSH330214CS	Child	DSH	NYU Langone Hospitals	Fink Children’s Ambulatory Care Center	160 East 32nd St	New York	NY	Active
DSH330214CT	Child	DSH	NYU Langone Hospitals	Diabetic Foot & Ankle Center	318 East 23rd Street	New York	NY	Active
DSH330214CU	Child	DSH	NYU Langone Hospitals	HCC Electroconvulsive Therapy	550 1st Avenue	New York	NY	Terminated
DSH330214CV	Child	DSH	NYU Langone Hospitals	Tisch Cardiovascular Services	550 First Avenue	New York	NY	Terminated
DSH330214CW	Child	DSH	NYU Langone Hospitals	HCC Cardiovascular Services	550 1st Avenue	New York	NY	Terminated
DSH330214CX	Child	DSH	NYU Langone Hospitals	Tisch Radiology	550 1st Avenue	New York	NY	Terminated
DSH330214CY	Child	DSH	NYU Langone Hospitals	Tisch Radiation Oncology	550 1st Avenue	New York	NY	Terminated
DSH330214CZ	Child	DSH	NYU Langone Hospitals	Tisch Acute Care	550 1st Avenue	New York	NY	Terminated
DSH330214D	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center-34th Street- Breast Imaging	160 East 34th Street	New York	NY	Terminated
DSH330214DA	Child	DSH	NYU Langone Hospitals	HCC Peri-Op	550 1st Avenue	New York	NY	Terminated
DSH330214DB	Child	DSH	NYU Langone Hospitals	HCC Acute Care	550 1st Avenue	New York	NY	Terminated
DSH330214DC	Child	DSH	NYU Langone Hospitals	Tisch Opthamology	550 1st Avenue	New York	NY	Terminated
DSH330214DD	Child	DSH	NYU Langone Hospitals	NYU Langone Transplant Institute	317 East 34th Street	New York	NY	Active
DSH330214DE	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center—Midwood	902 Quentin Road	Brooklyn	NY	Active
DSH330214DF	Child	DSH	NYU Langone Hospitals	NYU Langone Hospitals, Perlmutter Cancer Center—Huntington	789 Park Avenue	Huntington	NY	Active
DSH330214DG	Child	DSH	NYU Langone Hospitals	NYU Langone Fink Endocrine - Endocrine	150 East 32nd Street	New York	NY	Active
DSH330214DH	Child	DSH	NYU Langone Hospitals	NYU Langone Fink Cardiology - Cardiology	150 East 32nd Street	New York	NY	Active
DSH330214DJ	Child	DSH	NYU Langone Hospitals	NYU Langone Fink Pediatrics - Pediatrics	150 East 32nd Street	New York	NY	Active
DSH330214DK	Child	DSH	NYU Langone Hospitals	NYU Langone Fink Nephrology - Nephrology	150 East 32nd Street	New York	NY	Active
DSH330214DL	Child	DSH	NYU Langone Hospitals	NYU Langone Ambulatory Pharmacy Services	550 First Avenue	New York	NY	Terminated
DSH330214DM	Child	DSH	NYU Langone Hospitals	NYU Langone Fink Behavioral Health	135 East 31st Street	New York	NY	Active
DSH330214DN	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Electrophysiology Lab	259 First Street	Mineola	NY	Active
DSH330214DP	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Mineola Dialysis	200 Old Country Road	Mineola	NY	Active
DSH330214DQ	Child	DSH	NYU Langone Hospitals	Wound Healing and Hyperbaric Medicine at NYU Langone Hospital - Long Island	211 Station Road	Mineola	NY	Active
DSH330214DR	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Operating Room	259 First Street	Mineola	NY	Active
DSH330214DS	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Nuclear Medicine	259 First Street	Mineola	NY	Active
DSH330214DT	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island MRI	120 Mineola Blvd	Mineola	NY	Terminated
DSH330214DU	Child	DSH	NYU Langone Hospitals	NYU Langone Essex Crossing Ambulatory Surgery	171 Delancey Street	New York	NY	Active
DSH330214DV	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Diabetes Education Center	173 Mineola Blvd	Mineola	NY	Terminated
DSH330214DW	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Labor and Delivery	259 First Street	Mineola	NY	Active
DSH330214DX	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Breast Imaging Center	120 Mineola Blvd	Mineola	NY	Active
DSH330214DY	Child	DSH	NYU Langone Hospitals	NYCyberKnife at Perlmutter Cancer Center - Manhattan	150 Amsterdam Avenue	New York	NY	Active
DSH330214DZ	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Cardiac Cath Lab	259 First Street	Mineola	NY	Active
DSH330214E	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center - 34th Street - Diagnostic Imaging	160 East 34th Street	New York	NY	Active
DSH330214EA	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Endoscopy	259 First Street	Mineola	NY	Active
DSH330214EB	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island MRI	259 First Street	Mineola	NY	Active
DSH330214EC	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Women's Wellness OB GYN	1 Fulton Avenue	Hempstead	NY	Active
DSH330214ED	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island PET Scan	259 First Street	Mineola	NY	Terminated
DSH330214EE	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Radiation Oncology	259 First Street	Mineola	NY	Active
DSH330214EF	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Radiology PET/CT Scan	259 First Street	Mineola	NY	Active
DSH330214EG	Child	DSH	NYU Langone Hospitals	NYU Winthrop Hospital Acute Dialysis - NYU Winthrop Hospital Acute Dialysis	259 First Street	Mineola	NY	Terminated
DSH330214EH	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center at NYU Langone Hospital - Long Island Radiation Oncology	264 Old Country Road	Mineola	NY	Active
DSH330214EJ	Child	DSH	NYU Langone Hospitals	NYU Langone Fink Diabetes	135 East 31st Street	New York	NY	Active
DSH330214EK	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Radiology Diagnostic	259 First Street	Mineola	NY	Active
DSH330214EL	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Non-Invasive Cardiology	259 First Street	Mineola	NY	Active
DSH330214EM	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Pediatric Center	175 Fulton Avenue	Hempstead	NY	Active
DSH330214EN	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island ASU	259 First Street	Mineola	NY	Active
DSH330214EP	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Infusion Center	200 Old Country Road	Mineola	NY	Terminated
DSH330214EQ	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Hempstead High School Based Clinic	201 President Street	Hempstead	NY	Active
DSH330214ER	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Radiology Special Procedures	259 First Street	Mineola	NY	Active
DSH330214ES	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center Infusion Center at NYU Langone - 120 Mineola Boulevard	120 Mineola Blvd	Mineola	NY	Active
DSH330214ET	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Bethpage Dialysis	530 Hicksville Road	Bethpage	NY	Active
DSH330214EU	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Sun Harbor Dialysis	255 Warner Avenue	Roslyn Heights	NY	Terminated
DSH330214EV	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Hyperbaric	259 First Street	Mineola	NY	Active
DSH330214EW	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Special Procedures	222 Station Plaza	Mineola	NY	Active
DSH330214EX	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Ambulatory Surgery Center - Garden City	777 Zeckendorf Blvd	Garden City	NY	Active
DSH330214EY	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Blood Draw Station	222 Station Plaza	Mineola	NY	Terminated
DSH330214EZ	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Primary Care Clinic - Mineola	222 Station Plaza	Mineola	NY	Active
DSH330214F	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center - 34th Street - Hematology/Oncology	160 East 34th Street	New York	NY	Active
DSH330214FA	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Sleep Disorder Center	1300 Franklin Avenue	Garden City	NY	Active
DSH330214FB	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Cancer Center For Kids	120 Mineola Blvd	Mineola	NY	Active
DSH330214FC	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Emergency Department	259 First Street	Mineola	NY	Active
DSH330214FD	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Radiology	120 Mineola Blvd	Mineola	NY	Active
DSH330214FE	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Recovery Room	259 First Street	Mineola	NY	Terminated
DSH330214FF	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Sonography	259 First Street	Mineola	NY	Terminated
DSH330214FG	Child	DSH	NYU Langone Hospitals	NYU Langone Health - Transplant Rivergate	403 East 34th Street	New York	NY	Active
DSH330214FH	Child	DSH	NYU Langone Hospitals	Inflammatory Bowel Disease Center	305 E. 33rd Street	New York	NY	Active
DSH330214FJ	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center - Hematology/Oncology Clinic - Blood & Marrow Transplant	610 Second Avenue	New York	NY	Active
DSH330214FK	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center at Joseph S. and Diane H. Steinberg Ambulatory Care Center at NYU Langone - Oncology	70 Atlantic Avenue	Brooklyn	NY	Active
DSH330214FL	Child	DSH	NYU Langone Hospitals	Joseph S. and Diane H. Steinberg Same Day Surgery - Same Day Surgery	70 Atlantic Avenue	Brooklyn	NY	Active
DSH330214FM	Child	DSH	NYU Langone Hospitals	Joseph S. and Diane H. Steinberg Ambulatory Care Center - Cardiology - Cardiology	70 Atlantic Avenue	Brooklyn	NY	Active
DSH330214FN	Child	DSH	NYU Langone Hospitals	Joseph S. and Diane H. Steinberg Ambulatory Care Center - Nuclear Medicine - Nuclear Medicine	70 Atlantic Avenue	Brooklyn	NY	Active
DSH330214FP	Child	DSH	NYU Langone Hospitals	Joseph S. and Diane H. Steinberg Ambulatory Care Center - CT Scan - CT Scan	70 Atlantic Avenue	Brooklyn	NY	Active
DSH330214FQ	Child	DSH	NYU Langone Hospitals	Joseph S. and Diane H. Steinberg Ambulatory Care Center - MRI - MRI	70 Atlantic Avenue	Brooklyn	NY	Active
DSH330214FR	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Pulmonary Rehab - Pulmonary Rehab	100 Hospital Road	Patchogue	NY	Approved
DSH330214FS	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Cardiac Rehab - Cardiac Rehab	100 Hospital Road	Patchogue	NY	Approved
DSH330214FT	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Perioperative Services - Perioperative Services	101 Hospital RD	Patchogue	NY	Approved
DSH330214FU	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Recovery Services - Recovery Services	101 Hospital RD	Patchogue	NY	Approved
DSH330214FV	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Radiology-Diagnostic - Radiology-Diagnostic	101 Hospital Road	Patchogue	NY	Approved
DSH330214FW	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Emergency Medicine - Emergency Medicine	101 Hospital Road	Patchogue	NY	Approved
DSH330214FX	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Radiology-Special Procedures - Radiology-Special Procedures	101 Hospital Road	Patchogue	NY	Approved
DSH330214FY	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - EKG - EKG	101 Hospital Road	Patchogue	NY	Approved
DSH330214FZ	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Radiology-Ultrasound - Radiology-Ultrasound	101 Hospital Road	Patchogue	NY	Approved
DSH330214G	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center - 34th Street - Infusion Center	160 East 34th Street	New York	NY	Active
DSH330214GA	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Non-Invasive Cardiology - Non-Invasive Cardiology	101 Hospital Road	Patchogue	NY	Approved
DSH330214GB	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Anesthesiology - Anesthesiology	101 Hospital Road	Patchogue	NY	Approved
DSH330214GC	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Radiology-Cat Scan - Radiology-Cat Scan	101 Hospital Road	Patchogue	NY	Approved
DSH330214GD	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Radiology-MRI - Radiology-MRI	101 Hospital Road	Patchogue	NY	Approved
DSH330214GE	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Cardiac and Vascular Services - Cardiac and Vascular Services	101 Hospital Road	Patchogue	NY	Approved
DSH330214GF	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Infusion Services - Infusion Services	101 Hospital Road	Patchogue	NY	Approved
DSH330214GG	Child	DSH	NYU Langone Hospitals	Suffolk Dialysis Center - Dialysis	109 West Main St	Shirley	NY	Approved
DSH330214GH	Child	DSH	NYU Langone Hospitals	Outpatient Chemical Dependency Center - Chemical Dependency Center	550 Montauk Highway	Shirley	NY	Approved
DSH330214GJ	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Suffolk - Wound Care & Hyperbaric Medicine - Wound Care & Hyperbaric Medicine	33 Medford Avenue	Patchogue	NY	Approved
DSH330214GK	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center Radiation Oncology at NYU Langone - Mineola - Radiation Oncology	200 Old Country Road	Mineola	NY	Approved
DSH330214GL	Child	DSH	NYU Langone Hospitals	NYU Langone Hospital - Long Island Endoscopy Center, Mineola - Endoscopy	211 Station Road	Mineola	NY	Approved
DSH330214GM	Child	DSH	NYU Langone Hospitals	NYU Langone Cardiac Rehabilitation—Mineola - Cardiac Rehabilitation	212 Jericho Turnpike	Mineola	NY	Approved
DSH330214H	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center - 34th Street - Radiation Oncology	160 East 34th Street	New York	NY	Active
DSH330214J	Child	DSH	NYU HOSPITALS CENTER	NYU Langone Levit Medical Arts Pavilion - Ambulatory Care	1616 East 13th Street	Brooklyn	NY	Terminated
DSH330214K	Child	DSH	NYU Langone Hospitals	NYU Langone Brooklyn Endoscopy & Ambulatory Surgery Center	1630 East 14th Street	Brooklyn	NY	Active
DSH330214L	Child	DSH	NYU Langone Hospitals	NYU Langone Rehabilitation at Levit Medical—Bensonhurst	1902 86th Street	Brooklyn	NY	Terminated
DSH330214M	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center - Lake Success	1999 Marcus Avenue	Lake Success	NY	Active
DSH330214N	Child	DSH	NYU Langone Hospitals	NYU Langone Endoscopy Center - Upper East Side	207 E. 84th Street	New York	NY	Active
DSH330214P	Child	DSH	NYU Langone Hospitals	Laura Perlmutter Center for Women's Imaging	221 Lexington Ave.	New York	NY	Active
DSH330214Q	Child	DSH	NYU Langone Hospitals	NYU Langone Ambulatory Care Center East 38th Street	240 East 38th Street, Floors 12, 13, 15, 16, 17, Ground and Mezzanine	New York	NY	Active
DSH330214R	Child	DSH	NYU Langone Hospitals	Helen L. & Martin S. Kimmel Hyperbaric & Advanced Wound Healing Center	240 East 38th Street, 13th Floor	New York	NY	Active
DSH330214S	Child	DSH	NYU Langone Hospitals	Center for the Study & Treatment of Pain	240 East 38th Street, 14th Floor	New York	NY	Active
DSH330214T	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center - 38th Street	240 East 38th Street, 18th Floor	New York	NY	Active
DSH330214U	Child	DSH	NYU Langone Hospitals	NYU Langone Gastroenterology Associates	240 East 38th Street, 23rd Floor	New York	NY	Terminated
DSH330214V	Child	DSH	NYU Langone Hospitals	Ambulatory Care Center - Outpatient Surgery	240 East 38th Street, Floors 3, 20, and 21	New York	NY	Active
DSH330214W	Child	DSH	NYU Langone Hospitals	Skin & Cancer Unit	240 East 38th Street, 11th and 12th Floor	New York	NY	Active
DSH330214X	Child	DSH	NYU Langone Hospitals	Multiple Sclerosis Comprehensive Care Center	240 East 38th Street, Floors 12, 13, and 18	New York	NY	Active
DSH330214Y	Child	DSH	NYU Langone Hospitals	Perlmutter Cancer Center - 38th Street - Hematology/Oncology	240 East 38th Street, Floors 19, 20	New York	NY	Active
DSH330214Z	Child	DSH	NYU Langone Hospitals	Harkness Center for Dance Injuries	318 East 23rd Street	New York	NY	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		LHOTA, JOSEPH Chief Financial Officer NYU Langone Health 6466343670	4/15/2025 1:55 PM
Details	340B ID	Update	New Registration		DSH330214FY	4/15/2025 1:55 PM
Details	Entity Name	Update	New Registration	NYU LANGONE HOSPITALS	NYU Langone Hospitals	4/15/2025 1:55 PM
Details	Entity Subname	Update	New Registration	NYU Langone Hospital - Suffolk - EKG	NYU Langone Hospital - Suffolk - EKG - EKG	4/15/2025 1:55 PM
Dates	Participating Approval Date	Update	New Registration		4/15/2025 1:55:01 PM	4/15/2025 1:55 PM
Details	State	Update	New Registration	Pending	Approved	4/15/2025 1:55 PM
Dates	Signed By Date	Update	New Registration		4/9/2025 6:40:03 PM	4/15/2025 1:55 PM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/15/2025 1:55 PM
Addresses	Main Address	Insert	New Registration		101 Hospital Road Patchogue, NY 11772	4/9/2025 6:33 PM
Addresses	Billing Address	Insert	New Registration		NYU Langone Hospitals PO Box 427 Elmsford, NY 10523	4/9/2025 6:33 PM
Addresses	Shipping Address	Insert	New Registration		Long Island Community Hospital 101 Hospital Road 2nd Floor Patchogue, NY 11772	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		00244211	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		02996078	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		02998552	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		02999026	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		02999062	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		02999071	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		03000048	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		03000057	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		03000066	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		03179260	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		04785324	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		00245529	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		02999695	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		02999719	4/9/2025 6:33 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1801992631	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1821138959	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1558809756	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1730695263	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1659470276	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1437230034	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1669578324	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1619341716	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1427616002	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1114925567	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1083612089	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1831197797	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1760480628	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1487743480	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1831910355	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1013724061	4/9/2025 6:33 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/9/2025 6:33 PM
Contacts	Primary Contact	Insert	New Registration		DaCosta, Kristopher Director of 340B and Pharmacy Business & Analytics NYU Langone Health 6467549356	4/9/2025 6:33 PM
Contacts	Authorizing Official	Insert	New Registration		LHOTA, JOSEPH Chief Financial Officer NYU Langone Health 6466343670	4/9/2025 6:33 PM
Details	Assistance Received From Date	Insert	New Registration			4/9/2025 6:33 PM
Details	Assistance Received To Date	Insert	New Registration			4/9/2025 6:33 PM
Details	Last Recertification Date	Insert	New Registration			4/9/2025 6:33 PM
Details	Grant Number	Insert	New Registration			4/9/2025 6:33 PM
Details	340B ID	Insert	New Registration			4/9/2025 6:33 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/9/2025 6:33 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/9/2025 6:33 PM
Details	Medicare Provider Number	Insert	New Registration		330214	4/9/2025 6:33 PM
Details	Entity Name	Insert	New Registration		NYU LANGONE HOSPITALS	4/9/2025 6:33 PM
Details	NOFO Number	Insert	New Registration			4/9/2025 6:33 PM
Details	Program Code	Insert	New Registration		DSH	4/9/2025 6:33 PM
Details	Entity Subname	Insert	New Registration		NYU Langone Hospital - Suffolk - EKG	4/9/2025 6:33 PM
Dates	Participating Approval Date	Insert	New Registration			4/9/2025 6:33 PM
Details	State	Insert	New Registration		Pending	4/9/2025 6:33 PM
Dates	Registration Date	Insert	New Registration		4/9/2025 6:33:34 PM	4/9/2025 6:33 PM
Dates	Signed By Date	Insert	New Registration			4/9/2025 6:33 PM
Dates	Start Date	Insert	New Registration			4/9/2025 6:33 PM
Terminations	Termination Comments	Insert	New Registration			4/9/2025 6:33 PM
Terminations	Termination Date	Insert	New Registration			4/9/2025 6:33 PM
Terminations	Termination Effective Date	Insert	New Registration			4/9/2025 6:33 PM
Terminations	Termination Reason	Insert	New Registration			4/9/2025 6:33 PM