Marc Cimmino, D.O.
Individual provider Active NPI Family Medicine Physician · Oakdale, NY
NPI 1669578159 · NPPES record last updated Jan 23, 2024
Key facts
- NPI
- 1669578159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 172519 (NY)
- Practice address
- 971 Montauk Hwy
Oakdale, NY 11769-1434 - Phone
- (631) 400-8400
- Fax
- (631) 772-2495
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Brookhaven Heart PLLC
Practice addresses (Care Compare)
325 E Main St
Suite 120
Patchogue, NY 11772-3114
Phone (631) 654-3278
Hospital & facility affiliations
- Catholic Home Care
- Good Samaritan Hospital Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080125000242 | NY | Practitioner - Family Practice | 9537241849 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 172519 | NY | MD | Family Medicine Physician |
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visiting Services, LLC | Current |
Accepting new patients | |
| Brookhaven Heart PLLC | Current |
Accepting new patients | |
| Cardiology Center of Ny PLLC | Current |
Accepting new patients |
Locations
906 Oak Tree Ave
Ste J
South Plainfield, NJ 07080
Phone (908) 222-8700
40 Bay Shore Ave
Bay Shore, NY 11706
Phone (631) 647-4567
7 W 45th St
Fl 9
New York, NY 10036
Phone (212) 867-1111
325 E Main St
Ste 120
Patchogue, NY 11772
Phone (631) 654-3278
240 N Main St
Spring Valley, NY 10977
Phone (845) 374-0410
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EEFCAA
- marc.cimmino@bh.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 172519 | NY | Yes |
| Sports Medicine (Neuromusculoskeletal Medicine) Physician | 204C00000X | 172519 | NY |
Addresses
Primary practice location
971 Montauk Hwy
Oakdale, NY 11769-1434
Mailing address
PO Box 318
East Islip, NY 11730-0318
Phone (631) 969-8700
Other practice location 1
1344 Middle Country Rd
Centereach, NY 11720-3583
Phone (631) 268-3010
Other providers in Oakdale, NY
- Nicholas Anthony Cavuoto
- Melodi Celikoyar
- Changes for Life Inc
- Francis Kenneth Chapman
- Lisa Alice Chase
- Elisabeth Clark
- Louisa Claude
- Sarah B Colefield
- Alexandra Coleman
- Patricia Arlene Colleary
All providers in Oakdale, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.