Organization Active NPI

Island Infectious Disease Medical PLLC

  • Infectious Disease Physician
  • Port Washington, NY
National Provider Identifier
1194548099
Registry record updated Nov 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
ISLAND INFECTIOUS DISEASE MEDICAL PLLC
Practice address
23 Murray Ave
Port Washington, NY 11050-3502
Phone
(347) 276-6116
Fax
(347) 276-6116
NPI assigned
Nov 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2024

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

Authorized official

Name
Dr. Daniel Griffin, MDNPI 1831125640
Title
President
Phone
(347) 276-6116

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

23 Murray Ave
Port Washington, NY 11050-3502

Mailing address

23 Murray Ave
Port Washington, NY 11050-3502
Phone (347) 276-6116

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250217002613 NY Part B Supplier - Clinic/Group Practice 0547780850 Receives reassigned benefits from 5 practitioners
Practice locations: Port Washington, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731801600000",
    "number": "1194548099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MURRAY AVE",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503502",
            "telephone_number": "347-276-6116",
            "fax_number": "347-276-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MURRAY AVE",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503502",
            "telephone_number": "347-276-6116",
            "fax_number": "347-276-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND INFECTIOUS DISEASE MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-17",
        "certification_date": "2024-11-17",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-276-6116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2024; 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.