NPIMap

Organization Active NPI

Long Island Integrative Functional Medicine, PC

  • Primary Care Clinic/Center
  • Smithtown, NY
National Provider Identifier
1295643138
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LONG ISLAND INTEGRATIVE FUNCTIONAL MEDICINE, PC
Practice address
100 Terry Rd
Smithtown, NY 11787-3811
Phone
(631) 979-7400
Fax
(631) 979-7440
NPI assigned
Aug 31, 2026
Last updated
Oct 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Authorized official

Name
Dr. Evangelia Lila Augoustiniatos, MDNPI 1811043003
Title
President
Phone
(631) 398-3206

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Integrative Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202D00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

100 Terry Rd
Smithtown, NY 11787-3811

Mailing address

100 Terry Rd
Smithtown, NY 11787-3811
Phone (631) 979-7400

National Provider Directory

National Provider Directory

Locations

100 Terry Rd
Smithtown, NY 11787
Phone (631) 979-7301

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791763200000",
    "number": "1295643138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TERRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873811",
            "telephone_number": "631-979-7400",
            "fax_number": "631-979-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TERRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873811",
            "telephone_number": "631-979-7400",
            "fax_number": "631-979-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND INTEGRATIVE FUNCTIONAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A",
        "authorized_official_last_name": "AUGOUSTINIATOS",
        "authorized_official_first_name": "EVANGELIA",
        "authorized_official_middle_name": "LILA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-398-3206",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "202D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "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 Oct 12, 2026; 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.