ISLAND COSMETIC AND RECONSTRUCTIVE SURGERY PLLC
NPI 1013038702
Plastic Surgery in Mineola, NY

Q: What is Island Cosmetic And Reconstructive Surgery PLLC's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Active since April 02, 2007

190 E JERICHO TPKE, MINEOLA, NY 11501(516) 977-9922(516) 977-9926 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 2, 2026, Aug 22, 2020 (2 updates tracked since 2020).

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About Island Cosmetic And Reconstructive Surgery Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ISLAND COSMETIC AND RECONSTRUCTIVE SURGERY PLLC (NPI 1013038702), doing business as Island Plastic Surgery, is a healthcare organization registered as a plastic surgery in Mineola, New York and active in the NPI registry since April 2007. The organization lists Shannon Boyd, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1013038702

Entity TypeOrganization

Primary Taxonomy208200000X

Legal Business NameISLAND COSMETIC AND RECONSTRUCTIVE SURGERY PLLC

Location Address190 E JERICHO TPKEMineola, NY 11501-2033

Mailing Address190 E Jericho TpkeMineola, NY 11501-2033 · (516) 977-9922 · Fax (516) 977-9926

Phone(516) 977-9922

Fax(516) 977-9926

Organization SubpartNo

Authorized OfficialShannon BoydOffice Manager · (516) 534-2121

Enumeration DateApril 2, 2007

Last NPPES UpdateFebruary 2, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 2, 2026

✔ NPI 1013038702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208200000X

License✔ Licensed in NY · 124739

Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

190 E JERICHO TPKE, Mineola, NY 11501

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Other Names 2

Doing Business AsIsland Plastic Surgery

Doing Business AsIsland Plastic Surgery Aesthetic & Wellness

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Island Cosmetic And Reconstructive Surgery Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Island Cosmetic And Reconstructive Surgery PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Micheline Goulart, M.D.

Plastic and Reconstructive Surgery

NPI 1568840940

1045 NORTHERN BLVD FL 2
Roslyn, NY 11576

(516) 279-2616

✔ PECOS3.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Island Cosmetic And Reconstructive Surgery PLLC's NPI number?

The NPI number for Island Cosmetic And Reconstructive Surgery PLLC is 1013038702. It was assigned to this organization in the NPPES registry on April 2, 2007. The provider is doing business as Island Plastic Surgery and Island Plastic Surgery Aesthetic & Wellness.

Where is Island Cosmetic And Reconstructive Surgery PLLC located?

Island Cosmetic And Reconstructive Surgery PLLC is located at 190 E Jericho Tpke, Mineola, NY 11501. The listed phone number is (516) 977-9922.

What is Island Cosmetic And Reconstructive Surgery PLLC's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Island Cosmetic And Reconstructive Surgery PLLC enrolled in Medicare?

Yes. Island Cosmetic And Reconstructive Surgery PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Island Cosmetic And Reconstructive Surgery PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Island Cosmetic And Reconstructive Surgery PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Island Cosmetic And Reconstructive Surgery PLLC was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.