Active NPI
Stephen Matthew Machlica
- Medical Physician Assistant
- Lake Grove, NY
National Provider Identifier
1386237576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 2835 Middle Country Road
Lake Grove, NY 11755 - Phone
- (316) 467-3564
- NPI assigned
- Feb 18, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
2835 Middle Country Road
Lake Grove, NY 11755
Mailing address
2835 Middle Country Road
Lake Grove, NY 11755
Phone (316) 467-3564
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Touro Un Col of Osteopathic Medicine, New York, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Port Jefferson Station, NY
- NPI 1396794574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710633600000",
"number": "1386237576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2835 MIDDLE COUNTRY ROAD",
"city": "LAKE GROVE",
"state": "NY",
"postal_code": "11755",
"telephone_number": "316-467-3564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2835 MIDDLE COUNTRY ROAD",
"city": "LAKE GROVE",
"state": "NY",
"postal_code": "11755",
"telephone_number": "316-467-3564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACHLICA",
"first_name": "STEPHEN",
"middle_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-18",
"last_updated": "2024-03-17",
"certification_date": "2023-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Grove, NY
- Eric Lubow, D.D.S.
- Lucille Lore, NP in Family Health, PLLC
- Luxottica of America Inc (Sears Optical #C0181)
- Luxottica of America Inc. (Lenscrafters at Macy's #3228)
- Luxottica of America Inc. (Lenscrafters #152)
- Anum Mahmood, RPA-C
- Ilana Malekan, MS, CGC
- Julie Manis, R.N., GNP, PMHNP
- Mandi Marcello, RN
- Eliza M Marcus, M.ED, LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.