NPIMap

Organization Active NPI

Orthopedic Assoc of Long Island Physicians & Medical Group PLLC

  • Durable Medical Equipment & Medical Supplies
  • Riverhead, NY
National Provider Identifier
1033860416
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ORTHOPEDIC ASSOC OF LONG ISLAND PHYSICIANS & MEDICAL GROUP PLLC
Practice address
715 Roanoke Ave
BLDG a Unit 3
Riverhead, NY 11901-2769
Phone
(631) 689-6698
Fax
(631) 751-5548
NPI assigned
Jan 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Steven M Puopolo, MD
Title
Principal Physician
Phone
(631) 689-6698

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

715 Roanoke Ave
BLDG a Unit 3
Riverhead, NY 11901-2769

Mailing address

PO Box 45776
Baltimore, MD 21297-5776
Phone (631) 689-4173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220317000234 NY DME Supplier - Physician - Orthopedic/Orthopedic Surgery 6204169147 Practice locations: Riverhead, NY

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Orthopedic Assoc of Long Island Physicians Medical Group PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1033860416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45776",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212975776",
            "telephone_number": "631-689-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 ROANOKE AVE",
            "address_2": "BLDG A UNIT 3",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012769",
            "telephone_number": "631-689-6698",
            "fax_number": "631-751-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC ASSOC OF LONG ISLAND PHYSICIANS & MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "PUOPOLO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRINCIPAL PHYSICIAN",
        "authorized_official_telephone_number": "631-689-6698",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.