CS Medical Associates, P.C.
Organization Active NPI Counselor · Amityville, NY
NPI 1790653236 · NPPES record last updated Oct 27, 2025
Key facts
- NPI
- 1790653236
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- Legal business name
- CS MEDICAL ASSOCIATES, P.C.
- Practice address
- 64 Broadway
Amityville, NY 11701-2702 - Phone
- (631) 696-4357
- NPI assigned
- Oct 27, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- CS MEDICAL ASSOCIATES, P.C.
Authorized official
- Name
- Tracey Wallace
- Title
- VP Ops
- Phone
- (631) 696-4357
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 7
Practitioners 114
-
Eileen Abramowitz, FNP
-
Sandra Agenor-Alexandre, PMHNP
-
Lora Allen, AGNP-MS
-
Sylvia Andreatto, NP
-
Samantha Bassett, CASAC, MHC-LP
-
Robert Blair, PMHNP, RN
-
Temitope Branco, NP
-
Kathleen Brown, NP
-
Michael Degnan, NP-C
-
Michelle Louise Eckhoff, LMFT
-
Regina K Fong, PMHNP-BC
-
Ashleigh Friedell, LMFT
-
Caroline Jean Gelling, PA-C
-
Alexandra Gleason, LMFT
-
Albert Anthony Guerra, LMFT
-
Micaela Gutlove, PMHNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2341408 | CS Medical Associates PC | Certificate of waiver | Mar 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180329000208 | NY | Part B Supplier - Clinic/Group Practice | 9335401454 |
Receives reassigned benefits from 95 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hempstead, NY; Shirley, NY; Port Jefferson, NY; Massapequa Park, NY; Hicksville, NY; Farmingville, NY; Amityville, NY |
National Provider Directory
- Tax ID family
- CS Medical Associates PC
- Part of
- CS Medical Associates PC
Locations
727 N Broadway
North Massapequa, NY 11758
Phone (516) 243-7909
1000 Main St
Ste 1S
Port Jefferson, NY 11777
Phone (631) 296-1113
1228 E Main St
Ste A
Riverhead, NY 11901
Phone 63169643572
2 Coraci Blvd
Ste 16
Shirley, NY 11967
2 Coraci Blvd
Ste 1516
Shirley, NY 11967
Phone (631) 315-2320
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | Yes |
Addresses
Primary practice location
64 Broadway
Amityville, NY 11701-2702
Mailing address
1377 Motor Pkwy Ste 102
Islandia, NY 11749-5249
Other providers in Amityville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2025. 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.
- 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.