NPIMap

Organization Active NPI

Island Medical Group, PC

  • Infectious Disease Physician
  • Plainview, NY
National Provider Identifier
1356455828
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
ISLAND MEDICAL GROUP, PC
Practice address
789 Old Country Rd
Plainview, NY 11803-4907
Phone
(516) 433-3600
Fax
(516) 433-9490
NPI assigned
Aug 19, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Steven Bourla, M.D.NPI 1649216367
Title
Managing Partner
Phone
(516) 433-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Gastroenterology Physician 207RG0100X NU
Infectious Disease Physician 207RI0200X NU Primary

Addresses

Primary practice location

789 Old Country Rd
Plainview, NY 11803-4907

Mailing address

789 Old Country Rd
Plainview, NY 11803-4907
Phone (516) 433-3600

Other identifiers 1

IdentifierTypeStateIssuer
00100918MedicaidNY

National Provider Directory

National Provider Directory

Locations

789 Old Country Rd
Plainview, NY 11803
Phone (516) 433-3600

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1356455828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034907",
            "telephone_number": "516-433-3600",
            "fax_number": "516-433-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034907",
            "telephone_number": "516-433-3600",
            "fax_number": "516-433-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BOURLA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "516-433-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00100918",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.