SOUTHWEST SUFFOLK, P.C (NPI# 1730428467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730428467 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST SUFFOLK, P.C |
| Other Organization Name | SIENA PROACTIVE INTERNAL MEDICINE |
| Practice Address |
48 Route 25a Suite 210 Smithtown NY 11787-1431 |
| Practice Telephone | 6314656225 |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2013-01-31 |
| Authorized Official Name | MRS. LORI HUMMEL (DIRECTOR) |
| Authorized Official Telephone | 6314656001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Siena Proactive Internal Medicine | Doing Business As Name - Organization |
| Street Address |
48 ROUTE 25A SUITE 210 |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787-1431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568460343 | Rakesh B Patel | Specialist | 48 Route 25a, Suite 103, Smithtown, NY 11787-1431 | 2005-07-14 |
| 1114345055 | Rakesh B. Patel Physician PC | Specialist | 48 Route 25a, Suite 103, Smithtown, NY 11787-1431 | 2014-03-28 |
| 1245586528 | North Shore Medical Group of The Mount Sinai School of Medicine | Internal Medicine | 48 Route 25a, Suite 303, Smithtown, NY 11787-1431 | 2012-07-24 |
| 1669748943 | Jessica Piccoli | Physician Assistant | 48 Route 25a, Medical Office Building, Suite 305, Smithtown, NY 11787-1431 | 2012-03-30 |
| 1083986418 | Joseph R Vitolo Md PC | Surgery | 48 Route 25a, Suite 308, Smithtown, NY 11787 | 2012-02-01 |
| 1205168739 | Nick H Gabriel Do PC | Surgery | 48 Route 25a, Suite 104, Smithtown, NY 11787-1431 | 2010-02-09 |
| 1851533699 | Richard Charles Feldstein | Internal Medicine | 48 Route 25a, Suite 107, Smithtown, NY 11787-1431 | 2009-03-25 |
| 1326206079 | Valentina Emilia Radianu | Anesthesiology | 48 Route 25a, Smithtown, NY 11787-1431 | 2008-05-29 |
| 1295992535 | Michael Raymond Weber | Internal Medicine | 48 Route 25a, Suite 103, Smithtown, NY 11787-1431 | 2008-05-22 |
| 1104096049 | Southwest Suffolk Medical, P.C. | Surgery | 48 Route 25a, Smithtown, NY 11787-1431 | 2008-03-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
| 1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
| 1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
| 1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
| 1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
| 1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
| 1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
| 1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
| 1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
| 1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134519580 | Stephanie Wallman | Family Medicine | 32 Lawrence Ave Ste 206, Smithtown, NY 11787-3605 | 2015-01-23 |
| 1629396429 | Eileen Landenberger Digiovanna | Family Medicine | 48 Redan Dr, Smithtown, NY 11787-4458 | 2010-05-04 |
| 1528134988 | Esther Sumitra-albert | Family Medicine | 1056 W Jericho Tpke, Smithtown, NY 11787-3212 | 2006-11-28 |
| 1477629400 | Mantia Medical Associates | Family Medicine | 496 Nesconset Highway, Ste 200, Smithtown, NY 11787 | 2006-11-28 |
| 1336228410 | Superio Jao Md PC | Family Medicine | 278a E Main St, Smithtown, NY 11787-2920 | 2006-11-02 |
| 1124117189 | James Yong Zhen Wu | Family Medicine | 732 Smithtown Bypass, Suite A51, Smithtown, NY 11787 | 2006-10-11 |
| 1669578985 | Nicholas Livrieri | Family Medicine | 321 Middle Country Road, Smithtown, NY 11787 | 2006-09-15 |
| 1407969819 | Superio Tan Jao | Family Medicine | 278a East Main St, Smithtown, NY 11787 | 2006-08-17 |
| 1427614734 | Optimum Health and Wellness | Family Medicine | 1056 W Jericho Tpke, Smithtown, NY 11787-3212 | 2019-05-13 |
| 1346768702 | Smithtown Integrated Health LLC | Family Medicine | 32 Lawrence Ave Ste 206, Smithtown, NY 11787-3605 | 2017-09-06 |
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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.