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OMNI MEDICAL 360 PLLC
NPI 1114780525
Internal Medicine in Smithtown, NY

Active since January 31, 2024
100 MAPLE AVE, SMITHTOWN, NY 11787(631) 813-7788 Get Directions Write a Review

NPPES record last updated: April 8, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Omni Medical 360 Pllc NPPES

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

OMNI MEDICAL 360 PLLC (NPI 1114780525) is a healthcare organization registered as an internal medicine in Smithtown, New York and active in the NPI registry since January 2024. The organization lists Matthew Lobosco, Owner, as its authorized official.

NPPES Registry Identity

NPI1114780525
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameOMNI MEDICAL 360 PLLC
Location Address100 MAPLE AVESmithtown, NY 11787-3519
Mailing Address100 Maple AveSmithtown, NY 11787-3519 · (631) 364-1700
Phone(631) 813-7788
Organization SubpartNo
Authorized OfficialMatthew LoboscoOwner · (631) 364-1700
Enumeration DateJanuary 31, 2024
Last NPPES UpdateApril 8, 2026
NPPES CertifiedApril 8, 2026
✔ NPI 1114780525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
100 MAPLE AVE, Smithtown, NY 11787
Open in Google Maps ↗

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Omni Medical 360 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 Omni Medical 360 PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Matthew Lobosco, M.D.
Internal Medicine
NPI 1487896148
515 VALLEY ST STE 203
Maplewood, NJ 07040
(908) 663-2929
✔ PECOS✔ Accepts Medicare57 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 Omni Medical 360 PLLC's NPI number?

The NPI number for Omni Medical 360 PLLC is 1114780525. It was assigned to this organization in the NPPES registry on January 31, 2024.

Where is Omni Medical 360 PLLC located?

Omni Medical 360 PLLC is located at 100 Maple Ave, Smithtown, NY 11787. The listed phone number is (631) 813-7788.

What is Omni Medical 360 PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Omni Medical 360 PLLC enrolled in Medicare?

Yes. Omni Medical 360 PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Omni Medical 360 PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Omni Medical 360 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 Omni Medical 360 PLLC was last updated on April 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.