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ISLAND WIDE MEDICAL CARE PLLC
NPI 1558049577
Dermatology in Massapequa, NY

Active since July 10, 2023
616 BROADWAY, MASSAPEQUA, NY 11758(516) 636-5021(516) 636-5023 Get Directions Write a Review

NPPES record last updated: July 11, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Island Wide Medical Care Pllc NPPES

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

ISLAND WIDE MEDICAL CARE PLLC (NPI 1558049577) is a healthcare organization registered as a dermatology in Massapequa, New York and active in the NPI registry since July 2023. The organization lists Frank Suppa, Owner, as its authorized official.

NPPES Registry Identity

NPI1558049577
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameISLAND WIDE MEDICAL CARE PLLC
Location Address616 BROADWAYMassapequa, NY 11758-5024
Mailing Address138 Main St # 1009East Rockaway, NY 11518-1702 · (516) 636-5021 · Fax (516) 636-5023
Phone(516) 636-5021
Fax(516) 636-5023
Organization SubpartNo
Authorized OfficialFrank SuppaOwner · (516) 636-5021
Enumeration DateJuly 10, 2023
Last NPPES UpdateJuly 11, 2023
NPPES CertifiedJuly 11, 2023
✔ NPI 1558049577 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
616 BROADWAY, Massapequa, NY 11758
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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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Island Wide Medical Care 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 Island Wide Medical Care PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Frank Suppa, D.O
Family Practice
NPI 1700199213
51-15 BEACH CHANNEL DRIVE
Far Rockaway, NY 11691
(516) 554-6477
✔ PECOS18 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 Island Wide Medical Care PLLC's NPI number?

The NPI number for Island Wide Medical Care PLLC is 1558049577. It was assigned to this organization in the NPPES registry on July 10, 2023.

Where is Island Wide Medical Care PLLC located?

Island Wide Medical Care PLLC is located at 616 Broadway, Massapequa, NY 11758. The listed phone number is (516) 636-5021.

What is Island Wide Medical Care PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Island Wide Medical Care PLLC enrolled in Medicare?

Yes. Island Wide Medical Care PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Island Wide Medical Care PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Island Wide Medical Care 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 Island Wide Medical Care PLLC was last updated on July 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.