Long Island Professional Medical Services PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1878871 Issued in NY

Legal business name

LONG ISLAND PROFESSIONAL MEDICAL SERVICES PC

Practice address

901 Stewart Ave
Ste 275
Garden City, NY 11530

Phone

(516) 877-1518

Fax

(516) 877-1561

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Philip Fortunato Spadafora, DONPI 1255386959

Title

Physician President

Phone

(516) 877-1518

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Philip Fortunato Spadafora, DO

  • Internal Medicine Physician
  • Garden City, NY
  • NPI 1255386959
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1295788966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 STEWART AVE",
            "address_2": "STE 275",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-877-1518",
            "fax_number": "516-877-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 STEWART AVE",
            "address_2": "STE 275",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-877-1518",
            "fax_number": "516-877-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND PROFESSIONAL MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "SPADAFORA",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "FORTUNATO",
        "authorized_official_title_or_position": "PHYSICIAN PRESIDENT",
        "authorized_official_telephone_number": "516-877-1518",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1878871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Garden City, NY
• Providers in Garden City, 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 May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.