NORTH SHORE DIGESTIVE MEDICINE PC
NPI 1407114960
Internal Medicine - Gastroenterology in Smithtown, NY
About North Shore Digestive Medicine Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTH SHORE DIGESTIVE MEDICINE PC (NPI 1407114960) is a healthcare organization registered as a gastroenterology in Smithtown, New York and active in the NPI registry since May 2012. The organization holds a CLIA Certificate of Compliance certificate valid through January 4, 2027 and lists Farzad Forohar, Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
North Shore Digestive Medicine Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
15Medicare enrollment records show 15 clinicians reassign Medicare billing to North Shore Digestive Medicine PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (15)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Compliance 33D1060709
North Shore Digestive Medicine PC · Smithtown, NYFrequently 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 North Shore Digestive Medicine PC's NPI number?
The NPI number for North Shore Digestive Medicine PC is 1407114960. It was assigned to this organization in the NPPES registry on May 2, 2012.
Where is North Shore Digestive Medicine PC located?
North Shore Digestive Medicine PC is located at 50 Route 111 Suite 302, Smithtown, NY 11787. The listed phone number is (516) 488-9427.
What is North Shore Digestive Medicine PC's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.
Is North Shore Digestive Medicine PC enrolled in Medicare?
Yes. North Shore Digestive Medicine PC is registered in the Medicare PECOS enrollment system.
When is North Shore Digestive Medicine PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through North Shore Digestive Medicine PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 4 Medicare specialties reassign their Medicare billing to North Shore Digestive Medicine PC. 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. The largest specialties are Certified Registered Nurse Anesthetist (CRNA) (6), Anesthesiology (5) and Pathology (3). Of these, 1 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does North Shore Digestive Medicine PC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 33D1060709) is associated with this NPI, valid through January 4, 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 North Shore Digestive Medicine PC was last updated on May 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# North Shore Digestive Medicine Pc · NPI 1407114960
Gastroenterology organization in Smithtown, New York. Organization record, active in the CMS NPPES registry since May 2, 2012.
## Identity
- **NPI:** 1407114960 (Entity type: Organization)
- **Enumerated:** May 2, 2012
- **Primary specialty:** Internal Medicine - Gastroenterology · taxonomy 207RG0100X
- **Organization subpart:** No
- **Authorized official:** Farzad Forohar, MEMBER
## Practice location
- **Address:** 50 ROUTE 111, SUITE 302, Smithtown, NY 11787-3738
- **Phone:** (516) 488-9427 · **Fax:** (800) 557-3140
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 15 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Certified Registered Nurse Anesthetist (CRNA) (6), Anesthesiology (5), Pathology (3); 1 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 2, 2012
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1407114960) · Data from the CMS NPPES public registry.