David Conway

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

017130-1 Issued in NY

Practice address

10 Medical Dr
Suite B
Port Jefferson Station, NY 11776-1590

Phone

(631) 474-1111

NPI assigned

Oct 30, 2013

Last updated

Oct 30, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mendelsohn Medical, PLLC

  • Neurology Physician
  • Stony Brook, NY
  • NPI 1437578127
  NPD (past)
• PJS Medical Diagnostic PLLC

  • Diagnostic Radiology Physician
  • Port Jefferson Station, NY
  • NPI 1609110295
  NPD (past)

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1164850004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MEDICAL DR",
            "address_2": "SUITE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761590",
            "telephone_number": "631-474-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEDICAL DR",
            "address_2": "SUITE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761590",
            "telephone_number": "631-474-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-30",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017130-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Michael Coniglio Jr., DDS
• Lori Jean Conlin, NURSE PRACTITIONER
• Danielle Connolly
• Gino A Consigliere, MD
• Renata M Conte, RPH
• Melissa Copeland, NP
• Keegan Corbett
• Core Chiropractic Rehabilitation PC
• Gina Cornicelli
• Stephanie Corrado, PA-C

• Physician Assistant in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.