Organization Active NPI

Rising Tide Habilitation Services Inc

  • Multi-Specialty Clinic/Center
  • Smithtown, NY
National Provider Identifier
1639048804
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
RISING TIDE HABILITATION SERVICES INC
Practice address
496 Smithtown Byp
Smithtown, NY 11787-5005
Phone
(631) 909-3863
NPI assigned
Nov 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Authorized official

Name
Mark Murray
Title
Director
Phone
(631) 948-4335

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

496 Smithtown Byp
Smithtown, NY 11787-5005

Mailing address

496 Smithtown Byp
Smithtown, NY 11787-5005

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1762214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1639048804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875005",
            "telephone_number": "631-909-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISING TIDE HABILITATION SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-948-4335"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.