NPIMap

Organization Active NPI

South Island Gastroenterology Associates PC

  • Gastroenterology Physician
  • Lawrence, NY
National Provider Identifier
1043628282
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SOUTH ISLAND GASTROENTEROLOGY ASSOCIATES PC
Practice address
141 Washington Ave
Lawrence, NY 11559-1669
Phone
(516) 650-4604
Fax
(800) 557-3140
NPI assigned
Jul 31, 2014
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Steven L Kadish, MDNPI 1154303683
Title
Physician / Owner - Incorporator
Phone
(516) 984-6472

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2097660South Island Gastroenterology Associates PC141 Washington Avenue, Suite 204, Lawrence, NY 11559ComplianceApr 11, 2028

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20141231000662 NY Part B Supplier - Clinic/Group Practice 6103149976 Receives reassigned benefits from 30 practitioners
Practice locations: Lawrence, NY; Oceanside, NY

National Provider Directory

National Provider Directory

Locations

141 Washington Ave
Ste 104
Lawrence, NY 11559

141 Washington Ave
Ste 204
Lawrence, NY 11559
Phone (516) 341-0990

141 Washington Ave
Lawrence, NY 11559
Phone (516) 320-1496

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJGCDA

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

NPPES NPI Registry

Primary practice location

141 Washington Ave
Lawrence, NY 11559-1669

Mailing address

743 Bryant St
Woodmere, NY 11598-2904
Phone (516) 650-4604

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 31, 2014.

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1043628282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 BRYANT ST",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115982904",
            "telephone_number": "516-650-4604",
            "fax_number": "800-557-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 WASHINGTON AVE",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591669",
            "telephone_number": "516-650-4604",
            "fax_number": "800-557-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ISLAND GASTROENTEROLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "KADISH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER - INCORPORATOR",
        "authorized_official_telephone_number": "516-984-6472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.