Individual provider Active NPI

Dorothy Mock, PA

  • Physician Assistant
  • West Islip, NY
National Provider Identifier
1417985904
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003215 Issued in NY
Practice address
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone
(631) 376-3000
NPI assigned
Jun 30, 2006
Last updated
May 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003215 NY Primary

Addresses

Primary practice location

1000 Montauk Hwy
West Islip, NY 11795-4927

Mailing address

PO Box 6010
Hauppauge, NY 11788-9010
Phone (631) 232-4000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060228000191 NY Practitioner - Physician Assistant 4183630213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689

1174 Route 112
Port Jefferson Station, NY 11776-8033
Phone (631) 642-9090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003215NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Feb 2, 2026 Accepting new patients
CHS Physician Partners, PC CurrentSince Feb 2, 2026 Accepting new patients

Locations

1174 Route 112
Port Jefferson Station, NY 11776
Phone (631) 509-1730

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1417985904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6010",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117889010",
            "telephone_number": "631-232-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "DOROTHY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.