LONG ISLAND PHYSICIAN AFFILIATES, PLLC (NPI# 1134634645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134634645 |
| Entity Type | Organization |
| Organization Name | LONG ISLAND PHYSICIAN AFFILIATES, PLLC |
| Practice Address |
635 Belle Terre Rd Ste 209 Port Jefferson NY 11777-1935 |
| Mailing Address |
333 Route 25a Ste 225 Rocky Point NY 11778-8802 |
| Practice Telephone | 6315031400 |
| Mailing Telephone | 6315031400 |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |
| Authorized Official Name | JOHN VON LINTIG (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 6315031400 |
| Is Organization Subpart | Y |
| Parent Organization Name | LONG ISLAND PHYSICIAN ASSOCIATES, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | LONG ISLAND PHYSICIAN AFFILIATES, PLLC | 333 Route 25a, Suite 225, Rocky Point, Ny 117788802 |
| Street Address |
635 BELLE TERRE RD STE 209 |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777-1935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275848970 | Samuel Pearce Brown | Physical Medicine & Rehabilitation | 635 Belle Terre Rd Ste 209, Port Jefferson, NY 11777-1987 | 2010-08-18 |
| 1679120679 | Karin Merrins | Nurse Practitioner | 635 Belle Terre Rd Ste 209, Port Jefferson, NY 11777-1987 | 2019-08-23 |
| 1215495700 | Staci Marie Clabough | Nurse Practitioner | 635 Belle Terre Rd Ste 209, Port Jefferson, NY 11777-1987 | 2019-03-04 |
| 1194107961 | Kristen Ann Klein | Nurse Practitioner | 635 Belle Terre Rd Ste 209, Port Jefferson, NY 11777 | 2015-06-29 |
| 1518256767 | Ross Eliott Lipton | Neuromusculoskeletal Medicine, Sports Medicine | 635 Belle Terre Rd Ste 209, Port Jefferson, NY 11777 | 2011-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1073097531 | Ministry for Hope, Inc. Montfort Therapeutic Residence | Residential Treatment Facility, Physical Disabilities | 100 Stonyhill Road, Port Jefferson, NY 11777 | 2018-09-20 |
| Find all providers in zip 11777 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
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|---|---|---|---|---|
| 1952911547 | Alexander Rances, Do P.C. | Anesthesiology | 123 Lafayette Street, 5th Floor, New York, NY 10013 | 2020-08-07 |
| 1609484567 | Gen Med Inc | Anesthesiology | 253 Route 211 East, 2nd Floor, Middletown, NY 10940 | 2020-07-16 |
| 1497374250 | Stanley Ikezi, Md PC | Anesthesiology | 188 18 Linden Blvd, Saint Albans, NY 11412-4028 | 2020-04-13 |
| 1417595224 | Regenerative Pain Center of Nj & Ny | Anesthesiology | 119 W 57th St Ste 717, New York, NY 10019-2302 | 2019-12-12 |
| 1790322477 | Bay Ridge Medical Care Pllc | Anesthesiology | 370 Bay Ridge Pkwy Lowr Level, Brooklyn, NY 11209-3176 | 2019-12-02 |
| 1255991022 | Rubin Anesthesia Pain Management, Pllc | Anesthesiology | 1103 Stewart Avenue, Suite 300, Garden City, NY 11530 | 2019-06-14 |
| 1467010751 | Health Quest Medical Practice, PC | Anesthesiology | 665 Stoneleigh Ave Ste 205, Carmel, NY 10512-4625 | 2019-05-31 |
| 1619531910 | Aristide Burducea, D.o LLC | Anesthesiology | 21925 Peck Ave, Queens Village, NY 11427-1121 | 2019-04-23 |
| 1013470277 | Bryant Park Ambulatory Medical Care PC | Anesthesiology | 36 W 44th St Ste 914, New York, NY 10036-8104 | 2019-04-12 |
| 1043785181 | Spine and Pain Consultant, Pllc | Anesthesiology | 860 5th Ave Ste 1b, New York, NY 10065-5856 | 2018-10-04 |
| Find all providers with the same taxonomy | ||||
| City | PORT JEFFERSON |
| Zip Code | 11777 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.