1. Home
  2. Directory
  3. New York
  4. Smithtown
  5. Nurse Practitioner
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

HOMEGROWN ESSENTIAL PEDIATRICS
NPI 1700636164
Nurse Practitioner - Primary Care in Smithtown, NY

Active since March 26, 2024CLIA 33D2134307 · Waiver
267 E MAIN ST BLDG C, SMITHTOWN, NY 11787(631) 248-2700(866) 456-0906 Get Directions Write a Review

NPPES record last updated: August 6, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Homegrown Essential Pediatrics NPPES

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

HOMEGROWN ESSENTIAL PEDIATRICS (NPI 1700636164), doing business as Homegrown Essential Wellness Pediatrics & Family, is a healthcare organization registered as a primary care in Smithtown, New York and active in the NPI registry since March 2024. The organization holds a CLIA Waiver certificate valid through July 30, 2027 and lists Heather Ann Riddle, Dnp, as its authorized official.

NPPES Registry Identity

NPI1700636164
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameHOMEGROWN ESSENTIAL PEDIATRICS
Location Address267 E MAIN ST BLDG CSmithtown, NY 11787-2847
Mailing Address267 E Main St Bldg CSmithtown, NY 11787-2847 · (631) 248-2700 · Fax (866) 456-0906
Phone(631) 248-2700
Fax(866) 456-0906
Organization SubpartNo
Authorized OfficialHeather Ann RiddleDnp · (631) 248-2700
Enumeration DateMarch 26, 2024
Last NPPES UpdateAugust 6, 2026
NPPES CertifiedAugust 6, 2026
✔ NPI 1700636164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
267 E MAIN ST BLDG C, Smithtown, NY 11787
Open in Google Maps ↗

Other Names 1

Doing Business AsHomegrown Essential Wellness Pediatrics & Family

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 33D2134307

Homegrown Essential Pediatrics · Smithtown, NY
Active · expires Jul 30, 2027
CLIA Number33D2134307
Laboratory TypePhysician Office
Certificate Effective DateJuly 31, 2025
Certificate Expiration DateJuly 30, 2027
Laboratory DirectorMs. Heather Riddle
Laboratory Phone(631) 248-2700
Laboratory LocationHomegrown Essential Pediatrics257 East Middle Country Road - Ste B, Smithtown, NY 11787
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

NANCY BALKON PHD, NP, FAANP
Nurse Practitioner
267 E MAIN ST BLDG C
SMITHTOWN, NY 11787
Suffolk County (631) 418-8069
DR. MARILENA MIRICA MD
Internal Medicine
267 E MAIN ST BLDG C
SMITHTOWN, NY 11787
Suffolk County (631) 418-8069
MRS. RACHELE D'AMBROSIO NP, AGNP-C
Nurse Practitioner (Adult Health)
267 E MAIN ST BLDG C
SMITHTOWN, NY 11787
Suffolk County (631) 418-8069
RONNI SOLLAZZO M.D.
Internal Medicine
267 E MAIN ST BLDG C
SMITHTOWN, NY 11787
Suffolk County (631) 418-8069
SARAH RAZIANO
Nurse Practitioner
267 E MAIN ST BLDG C
SMITHTOWN, NY 11787
Suffolk County (631) 257-5290
DR. DARA GAIL BRENER MD
Internal Medicine
267 E MAIN ST BLDG C
SMITHTOWN, NY 11787
Suffolk County (631) 418-8069

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 Homegrown Essential Pediatrics's NPI number?

The NPI number for Homegrown Essential Pediatrics is 1700636164. It was assigned to this organization in the NPPES registry on March 26, 2024. The provider is doing business as Homegrown Essential Wellness Pediatrics & Family.

Where is Homegrown Essential Pediatrics located?

Homegrown Essential Pediatrics is located at 267 E Main St Bldg C, Smithtown, NY 11787. The listed phone number is (631) 248-2700.

What is Homegrown Essential Pediatrics's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Homegrown Essential Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2134307) is associated with this NPI, valid through July 30, 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 Homegrown Essential Pediatrics was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 43 days 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.