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PORT JEFF MEDICINE, P.C.
NPI 1346770484
Internal Medicine in Port Jeff Sta, NY

Active since June 12, 2017CLIA 33D2110426 · Waiver
2 MEDICAL DR STE D, PORT JEFF STA, NY 11776(631) 331-5010(631) 331-5017 Get Directions Write a Review

NPPES record last updated: June 19, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 19, 2017, Jun 12, 2017 (2 updates tracked since 2017).

About Port Jeff Medicine, P.c. NPPES

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

PORT JEFF MEDICINE, P.C. (NPI 1346770484) is a healthcare organization registered as an internal medicine in Port Jeff Sta, New York and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Deepti Gupta, President/owner, as its authorized official.

NPPES Registry Identity

NPI1346770484
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePORT JEFF MEDICINE, P.C.
Location Address2 MEDICAL DR STE DPort Jeff Sta, NY 11776-1598
Mailing Address2 Medical Dr Ste DPort Jefferson Station, NY 11776-1598 · (631) 331-5010 · Fax (631) 331-5017
Phone(631) 331-5010
Fax(631) 331-5017
Organization SubpartNo
Authorized OfficialDeepti GuptaPresident/owner · (631) 331-5010
Enumeration DateJune 12, 2017
Last NPPES UpdateJune 19, 20172 updates tracked since enumeration
✔ NPI 1346770484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 196816
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.
2 MEDICAL DR STE D, Port Jeff Sta, NY 11776
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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 SINGLE 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 33D2110426

Port Jefferson Medicine PC · Port Jefferson Station, NY
Active · expires Mar 26, 2027
CLIA Number33D2110426
Laboratory TypePhysician Office
Certificate Effective DateMarch 15, 2016
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Deepti Gupta
Laboratory Phone(631) 331-5010
Laboratory LocationPort Jefferson Medicine PC2 Medical Drive - Suite D, Port Jefferson Station, NY 11776
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Port Jeff Medicine, P.C.'s NPI number?

The NPI number for Port Jeff Medicine, P.C. is 1346770484. It was assigned to this organization in the NPPES registry on June 12, 2017.

Where is Port Jeff Medicine, P.C. located?

Port Jeff Medicine, P.C. is located at 2 Medical Dr Ste D, Port Jeff Sta, NY 11776. The listed phone number is (631) 331-5010.

What is Port Jeff Medicine, P.C.'s specialty?

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

Does Port Jeff Medicine, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2110426) is associated with this NPI, valid through March 26, 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 Port Jeff Medicine, P.C. was last updated on June 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.