NPIMap

Organization Active NPI

True North Medical at North Suffolk PLLC

  • Neurology Physician
  • Port Jefferson Station, NY
National Provider Identifier
1639804628
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
TRUE NORTH MEDICAL AT NORTH SUFFOLK PLLC
Practice address
1010 Route 112 Ste 300
Port Jefferson Station, NY 11776-3386
Phone
(631) 886-4985
Fax
(631) 364-9119
NPI assigned
Jul 22, 2022
Last updated
Jun 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Dr. Warren Spinner, MDNPI 1164617544
Title
Administrator
Phone
(631) 364-9119

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
Neurology Physician 2084N0400X Primary

Addresses

Primary practice location

1010 Route 112 Ste 300
Port Jefferson Station, NY 11776-3386

Mailing address

600 Community Dr
Manhasset, NY 11030-3802
Phone (516) 419-0412

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221130001067 NY Part B Supplier - Clinic/Group Practice 0345618088 Receives reassigned benefits from 24 practitioners
Practice locations: Shirley, NY; Port Jefferson Station, NY; Commack, NY

National Provider Directory

National Provider Directory

Locations

6080 Jericho Tpke
Ste 100
Commack, NY 11725
Phone (631) 364-9119

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1639804628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303802",
            "telephone_number": "516-419-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 ROUTE 112 STE 300",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763386",
            "telephone_number": "631-886-4985",
            "fax_number": "631-364-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUE NORTH MEDICAL AT NORTH SUFFOLK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-22",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "SPINNER",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "631-364-9119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.