Organization Active NPI

Island Medical Associates, P.C.

  • Specialist
  • Amityville, NY
National Provider Identifier
1194869495
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ISLAND MEDICAL ASSOCIATES, P.C.
Practice address
618 Broadway
Amityville, NY 11701-2124
Phone
(631) 789-4040
Fax
(631) 789-4083
NPI assigned
Feb 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Karen Marten
Title
Officel Manager
Phone
(631) 789-4040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

618 Broadway
Amityville, NY 11701-2124

Mailing address

618 Broadway
Amityville, NY 11701-2124
Phone (631) 789-4040

Other identifiers 8

IdentifierTypeStateIssuer
027899OtherNYBLUE CROSS
14645OtherNYVYTRA
8459937OtherNYAETNA
7166538OtherNYLOCAL 1199
AZ00211OtherNYMDNY
001148OtherNJHORIZON HEALTHCARE
0445851003OtherNYCIGNA
ANC129OtherNYOXFORD

National Provider Directory

National Provider Directory

Locations

618 Broadway
#220
Amityville, NY 11701
Phone (631) 789-4040

Practitioners & affiliated clinicians

Practitioners 1

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": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194869495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012124",
            "telephone_number": "631-789-4040",
            "fax_number": "631-789-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012124",
            "telephone_number": "631-789-4040",
            "fax_number": "631-789-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTEN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OFFICEL MANAGER",
        "authorized_official_telephone_number": "631-789-4040",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "027899",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "14645",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "8459937",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCAL 1199",
            "identifier": "7166538",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AZ00211",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON HEALTHCARE",
            "identifier": "001148",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0445851003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "ANC129",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.