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MATTITUCK FAMILY MEDICINE PLLC
NPI 1538349949
Family Medicine in Mattituck, NY

Active since November 14, 2007CLIA 33D2289725 · Waiver
7555 MAIN RD, MATTITUCK, NY 11952(631) 298-1678(631) 298-1679 Get Directions Write a Review

NPPES record last updated: May 19, 2008. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Mattituck Family Medicine Pllc NPPES

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

MATTITUCK FAMILY MEDICINE PLLC (NPI 1538349949) is a healthcare organization registered as a family medicine in Mattituck, New York and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Cynthia Carlson, Owner, as its authorized official.

NPPES Registry Identity

NPI1538349949
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMATTITUCK FAMILY MEDICINE PLLC
Location Address7555 MAIN RDMattituck, NY 11952-1516
Mailing AddressPo Box 111Mattituck, NY 11952-0111 · (631) 298-1678 · Fax (631) 298-1679
Phone(631) 298-1678
Fax(631) 298-1679
Organization SubpartNo
Authorized OfficialCynthia CarlsonOwner · (631) 298-1678
Enumeration DateNovember 14, 2007
Last NPPES UpdateMay 19, 2008
✔ NPI 1538349949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 199364
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
7555 MAIN RD, Mattituck, NY 11952
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Other Identifiers 2

Medicare UPING32208NY
Medicaid01693365NY

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 33D2289725

Mattituck Family Medicine · Mattituck, NY
Active · expires Mar 26, 2027
CLIA Number33D2289725
Laboratory TypePhysician Office
Certificate Effective DateSeptember 14, 2023
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Kimberly A. Hsu
Laboratory Phone(934) 213-4499
Laboratory LocationMattituck Family Medicine10095 Main Rd, Mattituck, NY 11952
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 19

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

MRS. PAMELA ANN BABCOCK LCSW
Social Worker (Clinical)
7555 MAIN RD
MATTITUCK, NY 11952
Suffolk County (631) 298-8642
MR. ANGEL RILEY MCCARRICK LMSW
Social Worker
7555 MAIN RD
MATTITUCK, NY 11952
Suffolk County (631) 298-8642
PETER WILLIAM REDMOND DDS
Dentist (General Practice)
7555 MAIN RD
MATTITUCK, NY 11952
Suffolk County (631) 298-9168
MR. RICHARD CHRISTOPHER CLIFT LMSW
Social Worker
7555 MAIN RD
MATTITUCK, NY 11952
Suffolk County (631) 298-8642
NORTH FORK DENTAL ASSOCIATES PC
Dentist (General Practice)
7555 MAIN RD
MATTITUCK, NY 11952
Suffolk County (631) 298-9168
HOLLY LEBREUX
Counselor
7555 MAIN RD
MATTITUCK, NY 11952
Suffolk County (631) 298-8642
STEPHANIE THODE
Counselor (Mental Health)
7555 MAIN RD
MATTITUCK, NY 11952
Suffolk County (631) 298-8642
MRS. LISA ANN REYLING
Social Worker
7555 MAIN RD
MATTITUCK, NY 11952
Suffolk County (631) 298-8642

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 Mattituck Family Medicine PLLC's NPI number?

The NPI number for Mattituck Family Medicine PLLC is 1538349949. It was assigned to this organization in the NPPES registry on November 14, 2007.

Where is Mattituck Family Medicine PLLC located?

Mattituck Family Medicine PLLC is located at 7555 Main Rd, Mattituck, NY 11952. The listed phone number is (631) 298-1678.

What is Mattituck Family Medicine PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Mattituck Family Medicine PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2289725) 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 Mattituck Family Medicine PLLC was last updated on May 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.