Active NPI
Suffolk Vascular Associates, PLLC
- Vascular Surgery Physician
- Port Jefferson Station, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- Legal business name
- SUFFOLK VASCULAR ASSOCIATES, PLLC
- Practice address
- 1110 Hallock Ave
Port Jefferson Station, NY 11776-1210 - Phone
- (631) 476-9100
- NPI assigned
- Jan 27, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert L. Pollina, M.D.
- Title
- President
- Phone
- (631) 476-9100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | Primary |
Addresses
Primary practice location
1110 Hallock Ave
Port Jefferson Station, NY 11776-1210
Mailing address
1110 Hallock Ave
Port Jefferson Station, NY 11776-1210
Phone (631) 476-9100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2034522 | Suffolk Vascular Associates | Certificate of waiver | Dec 27, 2027 |
National Provider Directory
National Provider DirectoryLocations
5225 Route 347
Ste 60
Port Jefferson Station, NY 11776
Phone (631) 406-6676
75 N Country Rd
#T
Prt Jefferson, NY 11777
Phone 63147313204428
1149 Old Country Rd
Ste C4
Riverhead, NY 11901
Phone (631) 369-3474
Practitioners & affiliated clinicians
Practitioners 25
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.
-
- Vascular Surgery Physician
- Port Jefferson Station, NY
- NPI 1538317334
-
- Vascular Surgery Physician
- Port Jefferson Station, NY
- NPI 1013988088
-
- Vascular Surgery Physician
- Port Jefferson Station, NY
- NPI 1336300896
-
- Student in an Organized Health Care Education/Training Program
- Stony Brook, NY
- NPI 1619237195
-
- Vascular Surgery Physician
- Southampton, NY
- NPI 1548599533
-
- Student in an Organized Health Care Education/Training Program
- Southampton, NY
- NPI 1861847493
-
- Surgical Physician Assistant
- Port Jefferson Station, NY
- NPI 1992723167
-
- Anesthesiology Physician
- Rocky Point, NY
- NPI 1710964606
-
- Anesthesiology Physician
- Rocky Point, NY
- NPI 1043296106
-
- Anesthesiology Physician
- Rocky Point, NY
- NPI 1659358802
-
- Anesthesiology Physician
- Rocky Point, NY
- NPI 1629056247
-
- Anesthesiology Physician
- Rocky Point, NY
- NPI 1760469910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1720059926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 HALLOCK AVE",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117761210",
"telephone_number": "631-476-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 HALLOCK AVE",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117761210",
"telephone_number": "631-476-9100"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUFFOLK VASCULAR ASSOCIATES, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-27",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "POLLINA",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "631-476-9100",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.