Smithtown Primary Medical Care, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

120634-1 Issued in NY

Legal business name

SMITHTOWN PRIMARY MEDICAL CARE, P.C.

Practice address

100 Maple Ave
Smithtown, NY 11787-3502

Phone

(631) 265-7671

Fax

(631) 265-7692

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Ronald RothNPI 1891870234

Title

President

Phone

(631) 265-7671

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

Practitioners 5

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

• Ronald Roth, MD

  • Family Medicine Physician
  • Smithtown, NY
  • NPI 1891870234
  Medicare reassignment Care Compare group NPD Authorized official
• Priscilla Lamura, FNP

  • Family Nurse Practitioner
  • Smithtown, NY
  • NPI 1124749130
  Medicare reassignment Care Compare group NPD
• Barbara D Mazzola, ANP

  • Adult Health Nurse Practitioner
  • Smithtown, NY
  • NPI 1629106695
  Medicare reassignment Care Compare group NPD
• Michael L Randall, DO

  • Family Medicine Physician
  • Centereach, NY
  • NPI 1639196108
  NPD (past)
• Subba Rao Nagubadi, MD

  • Urology Physician
  • Valparaiso, IN
  • NPI 1417957457
  NPD (past)

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1326243536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAPLE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873502",
            "telephone_number": "631-265-7671",
            "fax_number": "631-265-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAPLE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873502",
            "telephone_number": "631-265-7671",
            "fax_number": "631-265-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHTOWN PRIMARY MEDICAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-265-7671"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "120634-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smithtown Integrated Health LLC
• Smithtown Medical Specialists, PC
• Smithtown Pediatric Group, PC
• Smithtown Physical Therapy and Chiropractic , PLLC
• Smithtown Prescription Center Inc (OnPoint Pharmacy of Smithtown)
• Smithtown Psychiatric Services LLP
• Smithtown Psychotherapy, LCSW PLLC
• Smithtown Radiology PC
• James Snyder Jr., M.D.
• Kimberly Duncan Snyder

• Family Medicine Physician in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.