Austin D Prince

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

601 Portion Rd Ste 2
Lake Ronkonkoma, NY 11779-4585

Phone

(631) 648-9708

NPI assigned

Sep 14, 2021

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brookhaven Heart PLLCGroup PAC ID 6305846114, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tender Loving Care, an Amedisys Company Home health agency, Medford, NY, CCN 337260

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: austin.prince@bh.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/EEFCAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brookhaven Heart PLLC

  • Cardiovascular Disease Physician
  • Patchogue, NY
  • NPI 1639260607
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tender Loving Care Health Care Services of Nassau Suffolk, LLC

  dba Tender Loving Care, an Amedisys Company

  • Home Health Agency
  • Medford, NY
  • NPI 1699715961
  Care Compare affiliation

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1821768557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 PORTION RD STE 2",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117794585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 PORTION RD STE 2",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117794585",
            "telephone_number": "631-648-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "AUSTIN",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Aprince@md365.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "601 Portion Rd Ste 2",
            "city": "Lake Ronkonkoma",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117794585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter Taormino
• Tara Jean Petrungaro, LCSW
• Saturne Phillip
• Marie T Pottanat, MD
• Olivia Poulin
• Maygan Procino
• PSCG Optics Inc (Sachem Eye Care)
• Qlimg Ronkonkoma Med Office
• Nicholas Quod
• Mohiba Rafiqi

• Physician Assistant in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.