SOUTH SHORE OSTEOPATHIC MEDICINE P.C.
NPI 1063768174
Clinic/Center - Primary Care in Brooklyn, NY
About South Shore Osteopathic Medicine P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH SHORE OSTEOPATHIC MEDICINE P.C. (NPI 1063768174) is a healthcare organization registered as a primary care in Brooklyn, New York and active in the NPI registry since July 2012. The organization lists Michael Yuryev, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Shore Osteopathic Medicine P.c. 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 South Shore Osteopathic Medicine P.C., which bills Medicare for the services this clinician delivers.
Clinician (1)
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 South Shore Osteopathic Medicine P.C.'s NPI number?
The NPI number for South Shore Osteopathic Medicine P.C. is 1063768174. It was assigned to this organization in the NPPES registry on July 26, 2012.
Where is South Shore Osteopathic Medicine P.C. located?
South Shore Osteopathic Medicine P.C. is located at 2409 Ocean Ave Unit 1F, Brooklyn, NY 11229. The listed phone number is (718) 444-7774.
What is South Shore Osteopathic Medicine P.C.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is South Shore Osteopathic Medicine P.C. enrolled in Medicare?
Yes. South Shore Osteopathic Medicine P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through South Shore Osteopathic Medicine P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to South Shore Osteopathic Medicine P.C.. 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 South Shore Osteopathic Medicine P.C. was last updated on October 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.
# South Shore Osteopathic Medicine P.c. · NPI 1063768174
Primary Care organization in Brooklyn, New York. Organization record, active in the CMS NPPES registry since July 26, 2012.
## Identity
- **NPI:** 1063768174 (Entity type: Organization)
- **Enumerated:** July 26, 2012
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Michael Yuryev, PRESIDENT
## Practice location
- **Address:** 2409 OCEAN AVE UNIT 1F, Brooklyn, NY 11229-3576
- **Phone:** (718) 444-7774 · **Fax:** (718) 444-7775
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 4, 2019
- **Other identifiers:** Other A100073001 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1063768174) · Data from the CMS NPPES public registry.