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
- Organization subpart
- No
Practitioners 25
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Vascular Surgery Physician
- Port Jefferson Station, NY
- NPI 1538317334
NY, Vascular Surgery
-
- Vascular Surgery Physician
- Port Jefferson Station, NY
- NPI 1013988088
NY, Vascular Surgery
-
- Vascular Surgery Physician
- Port Jefferson Station, NY
- NPI 1336300896
NY, Vascular Surgery
-
- Student in an Organized Health Care Education/Training Program
- Stony Brook, NY
- NPI 1619237195
NY
-
- Student in an Organized Health Care Education/Training Program
- Southampton, NY
- NPI 1861847493
NY
-
- 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
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 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041129000540 | NY | Part B Supplier - Clinic/Group Practice | 3375434582 |
Receives reassigned benefits from 7 practitioners Practice locations: Smithtown, NY; Riverhead, NY; Nesconset, NY; Port Jefferson Station, NY; Port Jefferson, NY; Amityville, NY; Hauppauge, NY; Patchogue, NY |
National Provider Directory
National Provider DirectoryLocations
1110 Hallock Ave
Port Jefferson Station, NY 11776
Phone (631) 476-9100
75 N Country Rd
#T
Prt Jefferson, NY 11777
Phone 63147313204428
1149 Old Country Rd
Ste C4
Riverhead, NY 11901
Phone (631) 369-3474
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
NPI Registry JSON
{
"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.