Organization Active NPI

Amityville Medical Care P.C.

  • Family Medicine Physician
  • Amityville, NY
National Provider Identifier
1780064642
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
224376-1 Issued in NY
Legal business name
AMITYVILLE MEDICAL CARE P.C.
Practice address
100 W Oak St
Amityville, NY 11701-2927
Phone
(631) 264-1800
Fax
(631) 264-1813
NPI assigned
Jun 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Authorized official

Name
Elena Borisovna Plavnik, M.D.
Title
Doctor
Phone
(631) 264-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 224376-1 NY Primary

Addresses

Primary practice location

100 W Oak St
Amityville, NY 11701-2927

Mailing address

100 W Oak St
Amityville, NY 11701-2927
Phone (631) 264-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151019001341 NY Part B Supplier - Clinic/Group Practice 9032428867 Receives reassigned benefits from 14 practitioners
Practice locations: Amityville, NY; Bethpage, NY; Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2341911Amityville Medical Care PC100 W Oak St, Amityville, NY 11701Certificate of waiverApr 9, 2028

National Provider Directory

National Provider Directory

Locations

121 W Oak St
Amityville, NY 11701

8 Seitz Dr
Bethpage, NY 11714
Phone (516) 243-9777

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439337600000",
    "number": "1780064642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W OAK ST",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012927",
            "telephone_number": "631-264-1800",
            "fax_number": "631-264-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W OAK ST",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012927",
            "telephone_number": "631-264-1800",
            "fax_number": "631-264-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMITYVILLE MEDICAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-05",
        "last_updated": "2015-08-12",
        "status": "A",
        "authorized_official_last_name": "PLAVNIK",
        "authorized_official_first_name": "ELENA",
        "authorized_official_middle_name": "BORISOVNA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "631-264-1800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "224376-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.

Verify at the official NPI Registry.