Organization Active NPI

South Bay Medical Care P.C.

  • Emergency Medicine Physician
  • Center Moriches, NY
National Provider Identifier
1366569352
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SOUTH BAY MEDICAL CARE P.C.
Practice address
625 Montauk Hwy
Center Moriches, NY 11934
Phone
(631) 878-7134
Fax
(631) 878-5118
NPI assigned
Mar 23, 2007
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. David T Goldman, M.D.NPI 1952377707
Title
Director
Phone
(631) 878-7134

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X

Addresses

Primary practice location

625 Montauk Hwy
Center Moriches, NY 11934

Mailing address

625 Montauk Hwy
Center Moriches, NY 11934
Phone (631) 878-7134

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090420000130 NY Part B Supplier - Clinic/Group Practice 3678620275 Receives reassigned benefits from 3 practitioners
Practice locations: Center Moriches, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0945992South Bay Medical Care PC625 Montauk Hwy, Center Moriches, NY 11934Certificate of waiverMar 23, 2027

National Provider Directory

National Provider Directory

Locations

625 Montauk Hwy
Ctr Moriches, NY 11934
Phone (631) 878-7134

Practitioners & affiliated clinicians

Practitioners 8

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": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1366569352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MONTAUK HWY",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "11934",
            "telephone_number": "631-878-7134",
            "fax_number": "631-878-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 MONTAUK HWY",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "11934",
            "telephone_number": "631-878-7134",
            "fax_number": "631-878-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY MEDICAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-878-7134",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Moriches, 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.
  • 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.