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ISLAND SURGICAL & VASCULAR GROUP, P.C.
NPI 1639116759
Surgery in Bay Shore, NY

Active since May 31, 2006
15 PARK AVE, BAY SHORE, NY 11706(631) 581-4400(631) 277-3750 Get Directions Write a Review

NPPES record last updated: December 1, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Island Surgical & Vascular Group, P.c. NPPES

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

ISLAND SURGICAL & VASCULAR GROUP, P.C. (NPI 1639116759) is a healthcare organization registered as a surgery in Bay Shore, New York and active in the NPI registry since May 2006. The organization lists Bradley David Cohen, President, as its authorized official.

NPPES Registry Identity

NPI1639116759
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameISLAND SURGICAL & VASCULAR GROUP, P.C.
Location Address15 PARK AVEBay Shore, NY 11706-7381
Mailing Address15 Park AveBay Shore, NY 11706-7381 · (631) 581-4400 · Fax (631) 277-3750
Phone(631) 581-4400
Fax(631) 277-3750
Organization SubpartNo
Authorized OfficialBradley David CohenPresident · (631) 581-4400
Enumeration DateMay 31, 2006
Last NPPES UpdateDecember 1, 2009
✔ NPI 1639116759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
15 PARK AVE, Bay Shore, NY 11706
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Other Identifiers 3

Medicaid00664668NY
Medicare PINW01511NY
Medicare ID-Type UnspecifiedW01511

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 Surgical & Vascular Group, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Island Surgical & Vascular Group, P.C., which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Alexander Melman, M.D.
Vascular Surgery
NPI 1821037698
15 PARK AVE
Bay Shore, NY 11706
(631) 581-4400
✔ PECOS✔ Accepts MedicareSame address
Christine Fanelli, NP
Nurse Practitioner
NPI 1689632622
15 PARK AVE
Bay Shore, NY 11706
(631) 581-4400
✔ PECOS✔ Accepts MedicareSame address
Manal Hegazy, M.D.
General Surgery
NPI 1457380024
15 PARK AVE
Bay Shore, NY 11706
(631) 581-4400
✔ PECOS✔ Accepts MedicareSame address
Charles Larosa, M.D.
Vascular Surgery
NPI 1619900438
15 PARK AVE
Bay Shore, NY 11706
(631) 581-4400
✔ PECOS✔ Accepts MedicareSame address
Rachel Gordon
General Surgery
NPI 1063703650
27005 76TH AVE
New Hyde Park, NY 11040
(718) 470-7000
✔ PECOS✔ Accepts Medicare24 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 Surgical & Vascular Group, P.C.'s NPI number?

The NPI number for Island Surgical & Vascular Group, P.C. is 1639116759. It was assigned to this organization in the NPPES registry on May 31, 2006.

Where is Island Surgical & Vascular Group, P.C. located?

Island Surgical & Vascular Group, P.C. is located at 15 Park Ave, Bay Shore, NY 11706. The listed phone number is (631) 581-4400.

What is Island Surgical & Vascular Group, P.C.'s specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Island Surgical & Vascular Group, P.C. enrolled in Medicare?

Yes. Island Surgical & Vascular Group, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Island Surgical & Vascular Group, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Island Surgical & Vascular Group, P.C., in General Surgery, Nurse Practitioner and Vascular Surgery. 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. Of these, 4 practice at this address. 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 Surgical & Vascular Group, P.C. was last updated on December 1, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.