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STATEN ISLAND MEDICAL PRACTICE, P.C.
NPI 1104142082
Clinic/Center - Primary Care in Staten Island, NY

Active since April 16, 2010
5405 HYLAN BLVD, STATEN ISLAND, NY 10312(718) 948-5475(718) 948-5479 Get Directions Write a Review

NPPES record last updated: April 16, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Staten Island Medical Practice, P.c. NPPES

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

STATEN ISLAND MEDICAL PRACTICE, P.C. (NPI 1104142082) is a healthcare organization registered as a primary care in Staten Island, New York and active in the NPI registry since April 2010. The organization lists Leonard J Marchetta, Physicians' Assistant, as its authorized official.

NPPES Registry Identity

NPI1104142082
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameSTATEN ISLAND MEDICAL PRACTICE, P.C.
Location Address5405 HYLAN BLVDStaten Island, NY 10312-5241
Mailing Address5405 Hylan BlvdStaten Island, NY 10312-5241 · (718) 948-5475 · Fax (718) 948-5479
Phone(718) 948-5475
Fax(718) 948-5479
Organization SubpartNo
Authorized OfficialLeonard J MarchettaPhysicians' Assistant · (718) 948-5475
Enumeration DateApril 16, 2010
✔ NPI 1104142082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in NY · 191751
5405 HYLAN BLVD, Staten Island, NY 10312
Open in Google Maps ↗

Other Identifiers 4

Other11177655Caqh
Medicaid01860833NY
Medicare PIN72411
Medicare UPING59515

Other Providers at the Same Location NPPES 8

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

DR. GUSTAVE STEPHEN DRIVAS M.D.,
Internal Medicine
5405 HYLAN BLVD
STATEN ISLAND, NY 10312
Richmond County (718) 948-3890
REKINECT LLC
Physical Therapist
5405 HYLAN BLVD
STATEN ISLAND, NY 10312
Richmond County (917) 397-9700
DR. MARK SAMAAN PT, DPT
Physical Therapist
5405 HYLAN BLVD
STATEN ISLAND, NY 10312
Richmond County (917) 397-9700
ROSY ROBEEL AZER
Physician Assistant
5405 HYLAN BLVD
STATEN ISLAND, NY 10312
Richmond County (917) 397-9700
BEACH NY PHYSICAL THERAPY OF STATEN ISLAND PLLC
Physical Medicine & Rehabilitation
5405 HYLAN BLVD
STATEN ISLAND, NY 10312
Richmond County (718) 634-3211
HUGUENOT MEDICAL SERVICES P.C.
Internal Medicine
5405 HYLAN BLVD, STUITE 1
STATEN ISLAND, NY 10312
Richmond County (718) 948-5475
STATEN ISLAND MEDICAL PROFESSIONAL PC
Internal Medicine
5405 HYLAN BLVD
STATEN ISLAND, NY 10312
Richmond County (718) 356-0207
MR. LEONARD JOSEPH MARCHETTA R-P.A.
Physician Assistant
5405 HYLAN BLVD
STATEN ISLAND, NY 10312
Richmond County (718) 948-5475

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 Staten Island Medical Practice, P.C.'s NPI number?

The NPI number for Staten Island Medical Practice, P.C. is 1104142082. It was assigned to this organization in the NPPES registry on April 16, 2010.

Where is Staten Island Medical Practice, P.C. located?

Staten Island Medical Practice, P.C. is located at 5405 Hylan Blvd, Staten Island, NY 10312. The listed phone number is (718) 948-5475.

What is Staten Island Medical Practice, P.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Staten Island Medical Practice, P.C. was last updated on April 16, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.