SG MEDICAL PROFESSIONAL PC
NPI 1457085615
Family Medicine in Staten Island, NY
About Sg Medical Professional Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SG MEDICAL PROFESSIONAL PC (NPI 1457085615) is a healthcare organization registered as a family medicine in Staten Island, New York and active in the NPI registry since July 2022. The organization lists Dov Hollander, Director Of Operations, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 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)
Sg Medical Professional Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
39Medicare enrollment records show 39 clinicians reassign Medicare billing to Sg Medical Professional PC, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 8
Nearest to this location (20)
See all 39Source: 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 Sg Medical Professional PC's NPI number?
The NPI number for Sg Medical Professional PC is 1457085615. It was assigned to this organization in the NPPES registry on July 13, 2022.
Where is Sg Medical Professional PC located?
Sg Medical Professional PC is located at 260 Christopher Ln Ste 102A, Staten Island, NY 10314. The listed phone number is (718) 362-1405.
What is Sg Medical Professional PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Sg Medical Professional PC enrolled in Medicare?
Yes. Sg Medical Professional PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Sg Medical Professional PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 39 clinicians in 8 Medicare specialties reassign their Medicare billing to Sg Medical Professional 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 Nurse Practitioner (23), Family Practice (7) and Anesthesiology (2). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Sg Medical Professional PC was last updated on May 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Sg Medical Professional Pc · NPI 1457085615
Family Medicine organization in Staten Island, New York. Organization record, active in the CMS NPPES registry since July 13, 2022.
## Identity
- **NPI:** 1457085615 (Entity type: Organization)
- **Enumerated:** July 13, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Dov Hollander, DIRECTOR OF OPERATIONS
## Practice location
- **Address:** 260 CHRISTOPHER LN STE 102A, Staten Island, NY 10314-1631
- **Phone:** (718) 362-1405 · **Fax:** (718) 414-1651
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 39 clinicians in 8 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (23), Family Practice (7), Anesthesiology (2); [full list](https://npiprofile.com/npi/1457085615/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 30, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1457085615) · Data from the CMS NPPES public registry.