NPIMap

Organization Active NPI

Risewell Community Services

  • Clinic/Center
  • Wyandanch, NY
National Provider Identifier
1275927600
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
RISEWELL COMMUNITY SERVICES
Practice address
240A Long Island Ave
Wyandanch, NY 11798-3123
Phone
(631) 782-6200
Fax
(631) 491-5354
NPI assigned
Mar 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Authorized official

Name
Stephen McCarthy, CFO
Title
Chief Financial Officer
Phone
(631) 669-5355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NY Primary

Addresses

Primary practice location

240A Long Island Ave
Wyandanch, NY 11798-3123

Mailing address

1 Farmingdale Road
Route 109
West Babylon, NY 11704
Phone (631) 669-5355

Other identifiers 1

IdentifierTypeStateIssuer
WEY681OtherNYMEDICARE PTAN

Other names 1

  • Federation of Organizations for the NYS Mentally Disabled Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050721001040 NY Part B Supplier - Clinic/Group Practice 6800823782 Receives reassigned benefits from 25 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wyandanch, NY; West Babylon, NY; Patchogue, NY; Copiague, NY; Brooklyn, NY

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Risewell Community Services30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

240 Long Island Ave
Wyandanch, NY 11798
Phone (631) 782-6200

Practitioners & affiliated clinicians

Practitioners 7

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": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1275927600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FARMINGDALE ROAD",
            "address_2": "ROUTE 109",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "11704",
            "telephone_number": "631-669-5355",
            "fax_number": "631-669-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240A LONG ISLAND AVE",
            "city": "WYANDANCH",
            "state": "NY",
            "postal_code": "117983123",
            "telephone_number": "631-782-6200",
            "fax_number": "631-491-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISEWELL COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "631-669-5355",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WEY681",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Federation of Organizations for the NYS Mentally Disabled",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wyandanch, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.