NPIMap

Organization Active NPI

Island Psychiatry, P.C.

  • Cognitive & Behavioral Psychologist
  • Port Jefferson, NY
National Provider Identifier
1609249754
Registry record updated May 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Legal business name
ISLAND PSYCHIATRY, P.C.
Practice address
200 Belle Terre Rd
Port Jefferson, NY 11777-1968
Phone
(631) 474-6000
NPI assigned
Nov 10, 2015
Reactivated
Jan 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2026

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

Authorized official

Name
Randall Solomon, M.D.NPI 1780733360
Title
Owner
Phone
(631) 474-8099

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X Primary

Addresses

Primary practice location

200 Belle Terre Rd
Port Jefferson, NY 11777-1968

Mailing address

200 Belle Terre Rd
Port Jefferson Station, NY 11777-1968
Phone (631) 474-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161220001752 NY Part B Supplier - Clinic/Group Practice 9032490610 Receives reassigned benefits from 15 practitioners
Practice locations: Port Jefferson Station, NY

National Provider Directory

National Provider Directory

Locations

33 Walt Whitman Rd
Ste 217
Huntington Station, NY 11746
Phone (631) 271-5070

55 Nesconset Hwy
Ste 1
Port Jefferson Station, NY 11776
Phone (631) 474-8099

55 Nesconset Hwy
Port Jefferson Station, NY 11776
Phone (631) 474-8099

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778889600000",
    "number": "1609249754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BELLE TERRE RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117771968",
            "telephone_number": "631-474-6000",
            "fax_number": "888-506-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BELLE TERRE RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771968",
            "telephone_number": "631-474-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND PSYCHIATRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2026-05-16",
        "certification_date": "2026-05-16",
        "deactivation_date": "2024-01-10",
        "reactivation_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "SOLOMON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-474-8099",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.