Active NPI
Family Medical Practice of Long Island P.C.
- Family Medicine Physician
- Amityville, NY
National Provider Identifier
1972678183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 168859
- Legal business name
- FAMILY MEDICAL PRACTICE OF LONG ISLAND P.C.
- Practice address
- 221 Broadway
Suite 207
Amityville, NY 11701-2780 - Phone
- (631) 786-5692
- Fax
- (631) 368-4891
- NPI assigned
- Nov 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert Polofsky, D.O.
- Title
- Owner
- Phone
- (631) 786-5692
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 168859 | NY | Primary |
Addresses
Primary practice location
221 Broadway
Suite 207
Amityville, NY 11701-2780
Mailing address
PO Box 230
Massapequa, NY 11758-0230
Phone (631) 786-5692
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21003100852 | Other | NY | BEECH STREET |
| 2849737 | Other | NY | CIGNA |
| 01558938 | Medicaid | NY | |
| 062449890 | Other | NY | GREAT WEST |
| 6004917 | Other | NY | GHI |
| 97F471 | Other | NY | BLUE CROSS BLUE SHIELD |
| 0490232 | Other | NY | AETNA |
| 080142404 | Other | NY | MEDICARE RRB |
| 2C8087 | Other | NY | HEALTHNET |
| DA48747A | Other | NY | MDNY |
| P398100 | Other | NY | OXFORD |
| 0490232 | Other | NY | USHC |
| 50767 | Other | NY | VYTRA |
| 168859 | Other | NY | HIP |
| 168859-A10 | Other | NY | HEALTHFIRST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Amityville, NY
- NPI 1902830557
-
- Medical Physician Assistant
- Amityville, NY
- NPI 1700828340
-
- Medical Physician Assistant
- Merrick, NY
- NPI 1770932303
-
- Physician Assistant
- Amityville, NY
- NPI 1336895689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1489622400000",
"number": "1972678183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 230",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117580230",
"telephone_number": "631-786-5692",
"fax_number": "631-368-4891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 BROADWAY",
"address_2": "SUITE 207",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117012780",
"telephone_number": "631-786-5692",
"fax_number": "631-368-4891"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY MEDICAL PRACTICE OF LONG ISLAND P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-22",
"last_updated": "2017-03-16",
"status": "A",
"authorized_official_last_name": "POLOFSKY",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "631-786-5692",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "NY",
"license": "168859",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEECH STREET",
"identifier": "21003100852",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2849737",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01558938",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "062449890",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "6004917",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "97F471",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0490232",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RRB",
"identifier": "080142404",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "2C8087",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDNY",
"identifier": "DA48747A",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P398100",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "USHC",
"identifier": "0490232",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VYTRA",
"identifier": "50767",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP",
"identifier": "168859",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHFIRST",
"identifier": "168859-A10",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amityville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.