NPIMap

Organization Active NPI

South Fork Medical Associates PC

  • Registered Dietitian
  • Southampton, NY
National Provider Identifier
1144288077
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
SOUTH FORK MEDICAL ASSOCIATES PC
Practice address
238 Old Town Road
Southampton, NY 11968
Phone
(631) 283-2100
Fax
(631) 283-5731
NPI assigned
May 2, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Michael B Israel, MDNPI 1366407009
Title
Practices Managing Member
Phone
(631) 283-2100

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary
Internal Medicine Physician 207R00000X NU
Surgery Physician 208600000X NU

Addresses

Primary practice location

238 Old Town Road
Southampton, NY 11968

Mailing address

PO Box 2340
Southampton, NY 11969-2340
Phone (631) 283-2100

National Provider Directory

National Provider Directory

Locations

238 Old Town Rd
Southampton, NY 11968
Phone (516) 283-2100

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1144288077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2340",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119692340",
            "telephone_number": "631-283-2100",
            "fax_number": "631-283-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 OLD TOWN ROAD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968",
            "telephone_number": "631-283-2100",
            "fax_number": "631-283-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FORK MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRACTICES MANAGING MEMBER",
        "authorized_official_telephone_number": "631-283-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.