Omni Medical 360 PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

OMNI MEDICAL 360 PLLC

Practice address

100 Maple Ave
Smithtown, NY 11787-3519

Phone

(631) 813-7788

NPI assigned

Jan 31, 2024

Organization subpart

No

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

Authorized official

Name

Matthew LoboscoNPI 1487896148

Title

Owner

Phone

(631) 364-1700

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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

• Matthew Lobosco, M.D.

  • Psychiatry Physician
  • Maplewood, NJ
  • NPI 1487896148

  NY

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1114780525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAPLE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873519",
            "telephone_number": "631-364-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAPLE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873519",
            "telephone_number": "631-813-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI MEDICAL 360 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-31",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "LOBOSCO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-364-1700"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Ohare, LCSW
• Jennifer Ann Olesuk, PHARMD
• Chrystyne Olivieri, DNP
• Thomas J Olivo, LCSW
• Kevin F Olson II, MD
• Omni Physical Therapy
• Oprx #11787, LLC
• Optima Care Smithtown LLC
• Optimum Care Family Medicine, LLC
• Optimum Care Family Medicine, LLC

• Internal Medicine Physician in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.