SHORE TO SHORE MEDICAL WELLNESS PLLC
NPI 1679211965
Specialist in Port Jefferson Station, NY

NPI Status: Active since May 25, 2022

Contact Information

1500 ROUTE 112 STE B
PORT JEFFERSON STATION, NY
ZIP 11776
Phone: (631) 343-4184

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Authorized Official
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Specialist

About SHORE TO SHORE MEDICAL WELLNESS PLLC

This page provides the complete NPI Profile along with additional information for Shore To Shore Medical Wellness Pllc, a provider established in Port Jefferson Station, New York operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1679211965 assigned on May 2022. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Shore To Shore Medical Wellness Pllc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Gregory Brevetti (Owner)

NPI: 1679211965
Provider Name: SHORE TO SHORE MEDICAL WELLNESS PLLC
Entity Type: Organization
Location Address: 1500 ROUTE 112 STE B PORT JEFFERSON STATION, NY 11776
Location Phone: (631) 343-4184
Mailing Address: 1500 ROUTE 112 STE B PORT JEFFERSON STATION, NY 11776
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 05-25-2022
Last Update Date: 02-17-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Specialist
Taxonomy Code: 174400000X
Type: Other Service Providers
Taxonomy Description: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: GREGORY BREVETTI
Authorized Official Title: OWNER
Authorized Official Phone: (917) 575-8907

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1679211965, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 14 → 1 + 4

Pos 4

Unchanged

Pos 5

Doubled → 4

Pos 6

Unchanged

Pos 7

Doubled → 2

Pos 8

Unchanged

Pos 9

Doubled → 12 → 1 + 2

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 2 → 4 1 → 2 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 4 + 9 + 4 + 1 + 2 + 9 + 1 + 2 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5

This NPI is valid

The calculated check digit is 5, which matches the last digit of 1679211965.