NPIMap

Organization Active NPI

Long Island Select Healthcare, Inc.

  • Developmental Disabilities Clinic/Center
  • Central Islip, NY
National Provider Identifier
1891240784
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
LONG ISLAND SELECT HEALTHCARE, INC.
Practice address
159 Carleton Ave
Central Islip, NY 11722-4172
Phone
(631) 650-2510
Fax
(631) 650-0497
NPI assigned
Aug 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Authorized official

Name
James Powell, MD
Title
Ceo
Phone
(631) 650-2085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

159 Carleton Ave
Central Islip, NY 11722-4172

Mailing address

159 Carleton Ave
Central Islip, NY 11722-4172
Phone (631) 650-2510

Other names 1

  • LISH, Inc. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161229000247 NY Part B Supplier - Clinic/Group Practice 5991086225 Receives reassigned benefits from 74 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Smithtown, NY; Central Islip, NY; Riverhead, NY; Port Jefferson Station, NY; Manorville, NY; Hauppauge, NY; Center Moriches, NY

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lish Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569542400000",
    "number": "1891240784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224172",
            "telephone_number": "631-650-2510",
            "fax_number": "631-650-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224172",
            "telephone_number": "631-650-2510",
            "fax_number": "631-650-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND SELECT HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-20",
        "last_updated": "2019-09-27",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-650-2085",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LISH, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Central Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.