NPIMap

Organization Active NPI

Middle Country Family Medicine P C

  • Family Medicine Physician
  • Centereach, NY
National Provider Identifier
1659542827
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200458 Issued in NY
Legal business name
MIDDLE COUNTRY FAMILY MEDICINE P C
Practice address
2539 Middle Country Rd
Suite 5
Centereach, NY 11720-3551
Phone
(631) 580-1740
Fax
(631) 580-1955
NPI assigned
Mar 17, 2008
Last updated
Mar 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Authorized official

Name
Dr. Michael L. Randall, D.O.NPI 1639196108
Title
President
Phone
(631) 580-1740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200458 NY Primary

Addresses

Primary practice location

2539 Middle Country Rd
Suite 5
Centereach, NY 11720-3551

Mailing address

2539 Middle Country Rd
Suite 5
Centereach, NY 11720-3551
Phone (631) 580-1740

National Provider Directory

National Provider Directory

Locations

2539 Middle Country Rd
Ste 5
Centereach, NY 11720
Phone (631) 580-1740

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395619200000",
    "number": "1659542827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 MIDDLE COUNTRY RD",
            "address_2": "SUITE 5",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203551",
            "telephone_number": "631-580-1740",
            "fax_number": "631-580-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 MIDDLE COUNTRY RD",
            "address_2": "SUITE 5",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203551",
            "telephone_number": "631-580-1740",
            "fax_number": "631-580-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE COUNTRY FAMILY MEDICINE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2014-03-24",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-580-1740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "200458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centereach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.