NPIMap

Organization Active NPI

Smithtown Family Health NP PC

  • Family Nurse Practitioner
  • Smithtown, NY
National Provider Identifier
1215560776
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SMITHTOWN FAMILY HEALTH NP PC
Practice address
300 E Main St Ste 2
Smithtown, NY 11787-2900
Phone
(631) 523-7826
NPI assigned
Feb 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
Doreen Smith, NPNPI 1669909560
Title
President
Phone
(631) 523-7826

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
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

300 E Main St Ste 2
Smithtown, NY 11787-2900

Mailing address

336 Nicolls Rd
Deer Park, NY 11729-1806
Phone (631) 523-7826

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200414001824 NY Part B Supplier - Clinic/Group Practice 9335579499 Receives reassigned benefits from 15 practitioners
Practice locations: East Setauket, NY; Sayville, NY; Smithtown, NY; Westhampton Beach, NY

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1215560776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 NICOLLS RD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291806",
            "telephone_number": "631-523-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST STE 2",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872900",
            "telephone_number": "631-523-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHTOWN FAMILY HEALTH NP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-12",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOREEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-523-7826",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.