Organization Active NPI

North Shore Plastic Surgery P.C.

  • Plastic and Reconstructive Surgery Physician
  • Melville, NY
National Provider Identifier
1942665732
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
NORTH SHORE PLASTIC SURGERY P.C.
Practice address
510 Broadhollow Rd Ste 100
Melville, NY 11747-3671
Phone
(631) 424-3600
Fax
(631) 424-2963
NPI assigned
Dec 21, 2015
Last updated
Jun 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Authorized official

Name
Katharine Pyne
Title
Manager
Phone
(631) 424-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X NY Primary

Addresses

Primary practice location

510 Broadhollow Rd Ste 100
Melville, NY 11747-3671

Mailing address

510 Broadhollow Rd Ste 100
Melville, NY 11747-3671
Phone (631) 424-3600

National Provider Directory

National Provider Directory

Locations

510 Broadhollow Rd
Ste 100
Melville, NY 11747
Phone (631) 424-3600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1942665732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 BROADHOLLOW RD STE 100",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473671",
            "telephone_number": "631-424-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BROADHOLLOW RD STE 100",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473671",
            "telephone_number": "631-424-3600",
            "fax_number": "631-424-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE PLASTIC SURGERY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "PYNE",
        "authorized_official_first_name": "KATHARINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "631-424-3600"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.