NPIMap

Organization Active NPI

Island Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Far Rockaway, NY
National Provider Identifier
1639160385
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ISLAND EMERGENCY MEDICAL SERVICES, P.C.
Practice address
327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone
(844) 474-4019
NPI assigned
Nov 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Authorized official

Name
Melissa Reese
Title
Provider Enrollment Officer
Phone
(330) 493-4443

Specialties & licenses 1

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

Addresses

Primary practice location

327 Beach 19TH St
Far Rockaway, NY 11691-4423

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (844) 474-4019

Other practice location 1

325 E Bay Dr
Long Beach, NY 11561-2357
Phone (844) 474-4019

Other practice location 2

50 New York Ave # 25A
Smithtown, NY 11787-3448
Phone (844) 474-4019

Other practice location 3

1 Healthy Way
Oceanside, NY 11572-1551
Phone (844) 474-4019

Other identifiers 2

IdentifierTypeStateIssuer
03010304MedicaidNY
W34971OtherNYGROUP NUMBER BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040102000662 NY Part B Supplier - Clinic/Group Practice 4981503513 Receives reassigned benefits from 442 practitioners
Practice locations: Albany, NY; Troy, NY; Smithtown, NY; Schenectady, NY; Halfmoon, NY; Far Rockaway, NY

National Provider Directory

National Provider Directory

Locations

200 Harborside Dr
Schenectady, NY 12305
Phone (518) 881-4470

Practitioners & affiliated clinicians

Practitioners 501

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

View all 501

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1639160385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "844-474-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423",
            "telephone_number": "844-474-4019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 E Bay Dr",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "NY",
            "postal_code": "115612357",
            "country_code": "US",
            "telephone_number": "844-474-4019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 New York Ave # 25A",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117873448",
            "country_code": "US",
            "telephone_number": "844-474-4019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "844-474-4019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ISLAND EMERGENCY MEDICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT OFFICER",
        "authorized_official_telephone_number": "330-493-4443"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03010304",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER BCBS",
            "identifier": "W34971",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.