Sea Medical Wellness PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SEA MEDICAL WELLNESS PC

Practice address

62 Joline Rd
Port Jefferson Station, NY 11776-3306

Phone

(631) 656-6231

NPI assigned

May 24, 2024

Organization subpart

No

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

Authorized official

Name

Farhad Gazi, MDNPI 1023278520

Title

Owner

Phone

(917) 328-9637

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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.

• Farhad Mohammad Gazi, MD

  • Emergency Medicine Physician
  • Forest Hills, NY
  • NPI 1023278520
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1275373516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 JOLINE RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763306",
            "telephone_number": "631-656-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 JOLINE RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763306",
            "telephone_number": "631-656-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA MEDICAL WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "GAZI",
        "authorized_official_first_name": "FARHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-328-9637",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michel Schwartz, NP
• Steven Schwartz, DDS, MD
• Michael Louis Scicchitano Sr., PT
• Lynn Scotti, MASSAGE THERAPIST
• Christine Scudero
• Diane Odessa Seaman, LCSW, BCD
• James A Seitz, LCSW
• Sumiko Lorena Seki, LMT
• Sensory Solutions of Long Island, Inc
• Kenneth Robert Sergiacomi, L.M.S.W.

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

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