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INNOVATIVE MEDICAL CARE PLLC
NPI 1063720910
Family Medicine in Deer Park, NY

Active since September 14, 2010CLIA 33D2064075 · Waiver
375 COMMACK RD UNIT A, DEER PARK, NY 11729(631) 940-1834(631) 940-1834 Get Directions Write a Review

NPPES record last updated: March 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Innovative Medical Care Pllc NPPES

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

INNOVATIVE MEDICAL CARE PLLC (NPI 1063720910) is a healthcare organization registered as a family medicine in Deer Park, New York and active in the NPI registry since September 2010. The organization holds a CLIA Waiver certificate valid through August 13, 2027, maintains a secondary practice location in Bellerose, and lists Behrouz Farahmandpour, President, as its authorized official.

NPPES Registry Identity

NPI1063720910
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameINNOVATIVE MEDICAL CARE PLLC
Location Address375 COMMACK RD UNIT ADeer Park, NY 11729-5522
Mailing Address375 Commack Rd Unit ADeer Park, NY 11729-5522 · (631) 940-1834 · Fax (631) 940-1834
Phone(631) 940-1834
Fax(631) 940-1834
Organization SubpartNo
Authorized OfficialBehrouz FarahmandpourPresident · (631) 940-0409
Enumeration DateSeptember 14, 2010
Last NPPES UpdateMarch 30, 2025
NPPES CertifiedMarch 30, 2025
✔ NPI 1063720910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 233446
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
375 COMMACK RD UNIT A, Deer Park, NY 11729
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Secondary Practice Location 1

Location 124711 Union TpkeBellerose, NY 11426-1846 · Phone (631) 940-0409 · Fax (631) 940-1834

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2064075

Innovative Medical Care PLLC · Deer Park, NY
Active · expires Aug 13, 2027
CLIA Number33D2064075
Laboratory TypePhysician Office
Certificate Effective DateAugust 14, 2025
Certificate Expiration DateAugust 13, 2027
Laboratory DirectorDr. Behrouz Farahmandpour
Laboratory Phone(631) 940-0409
Laboratory LocationInnovative Medical Care PLLC375A Commack Road, Deer Park, NY 11729
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEHROUZ FARAHMANDPOUR D.O.
Family Medicine
375 COMMACK RD UNIT A
DEER PARK, NY 11729
Suffolk County (631) 940-0409
BRIAN GERSON NP
Nurse Practitioner (Family)
375 COMMACK RD UNIT A
DEER PARK, NY 11729
Suffolk County (631) 940-0409

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 Innovative Medical Care PLLC's NPI number?

The NPI number for Innovative Medical Care PLLC is 1063720910. It was assigned to this organization in the NPPES registry on September 14, 2010.

Where is Innovative Medical Care PLLC located?

Innovative Medical Care PLLC is located at 375 Commack Rd Unit A, Deer Park, NY 11729. The listed phone number is (631) 940-1834.

What is Innovative Medical Care PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Innovative Medical Care PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2064075) is associated with this NPI, valid through August 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Innovative Medical Care PLLC was last updated on March 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.