South Shore Medical Care, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21762 Issued in NY

Legal business name

SOUTH SHORE MEDICAL CARE, PC

Practice address

16 Van Cott Rd
Suite 2E
Deer Park, NY 11729-6519

Phone

(631) 274-0777

Fax

(631) 274-9499

NPI assigned

Jun 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marc Albert Lewandoski, DONPI 1982676334

Title

Doctor

Phone

(631) 274-0777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• Marc Albert Lewandoski, DO

  • Family Medicine Physician
  • Deer Park, NY
  • NPI 1982676334
  Medicare reassignment NPD Authorized official
• Lauren E Bovelle, R.P.A.

  • Medical Physician Assistant
  • Deer Park, NY
  • NPI 1679826697
  Medicare reassignment
• Robert E Gribbin

  • Physical Therapist
  • Babylon, NY
  • NPI 1477880771
  NPD

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1861696171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 VAN COTT RD",
            "address_2": "SUITE 2E",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296519",
            "telephone_number": "631-274-0777",
            "fax_number": "631-274-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 VAN COTT RD",
            "address_2": "SUITE 2E",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296519",
            "telephone_number": "631-274-0777",
            "fax_number": "631-274-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE MEDICAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "LEWANDOSKI",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "631-274-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "21762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Smith
• Michelle Marie Sobel, L.P.N.
• Jerry A. Sokol, MD
• Christopher John Sorrentino, RPH
• South Shore Integrated Physical Therapy, Acupuncture and Massage PLLC (South Shore Integrated Therapy)
• Elana Jo Spahn
• Jenna Spatafora
• Olga Spathis, RPH
• Melanie Spitz
• Catherine St Julien

• Family Medicine Physician in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.