NPIMap

Organization Active NPI

Orthopedic Assoc of Long Island Physicians & Medical Group PLLC

  • Durable Medical Equipment & Medical Supplies
  • Wading River, NY
National Provider Identifier
1043872591
Registry record updated Jul 5, 2019
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
6144 Route 25a Ste 5
Wading River, NY 11792-2008
Phone
(631) 689-6698
Fax
(631) 751-5548
NPI assigned
Jul 5, 2019
Last updated
Jul 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Authorized official

Name
Steven M PuopoloNPI 1841398641
Title
Principle Physician
Phone
(631) 689-6698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

6144 Route 25a Ste 5
Wading River, NY 11792-2008

Mailing address

PO Box 45776
Baltimore, MD 21297-5776
Phone (631) 689-6698

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191021001124 NY DME Supplier - Physician - Orthopedic/Orthopedic Surgery 6204169147 Practice locations: Wading River, 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

Locations

6144 Route 25A
Ste 5
Wading River, NY 11792

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562284800000",
    "number": "1043872591",
    "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": "631-689-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6144 ROUTE 25A STE 5",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922008",
            "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": "2019-07-05",
        "last_updated": "2019-07-05",
        "status": "A",
        "authorized_official_last_name": "PUOPOLO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRINCIPLE PHYSICIAN",
        "authorized_official_telephone_number": "631-689-6698"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wading River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; 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.