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PATCHOGUE FAMILY MEDICAL CARE, PC
NPI 1700915113
Family Medicine in Patchogue, NY

Active since March 02, 2007CLIA 33D0970811 · Waiver
130 MEDFORD AVE, PATCHOGUE, NY 11772(631) 475-5734(631) 758-2568 Get Directions Write a Review

NPPES record last updated: March 22, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Patchogue Family Medical Care, Pc NPPES

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

PATCHOGUE FAMILY MEDICAL CARE, PC (NPI 1700915113) is a healthcare organization registered as a family medicine in Patchogue, New York and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through July 9, 2027 and lists Christine M Doucet, Owner, as its authorized official.

NPPES Registry Identity

NPI1700915113
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePATCHOGUE FAMILY MEDICAL CARE, PC
Location Address130 MEDFORD AVEPatchogue, NY 11772-1206
Mailing Address130 Medford AvePatchogue, NY 11772-1206 · (631) 475-5734 · Fax (631) 758-2568
Phone(631) 475-5734
Fax(631) 758-2568
Organization SubpartNo
Authorized OfficialChristine M DoucetOwner · (631) 475-5734
Enumeration DateMarch 2, 2007
Last NPPES UpdateMarch 22, 2011
✔ NPI 1700915113 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 · 214240
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.
130 MEDFORD AVE, Patchogue, NY 11772
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Other Identifiers 1

Medicare ID-Type UnspecifiedW3Z901NY

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)

Patchogue Family Medical Care, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Patchogue Family Medical Care, PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Christine Doucet, M.D.
Family Practice
NPI 1063596823
130 MEDFORD AVE
Patchogue, NY 11772
(631) 475-5734
✔ PECOS✔ Accepts MedicareSame address
Doreen Amankwah Owusu, MD
Family Practice
NPI 1922595891
130 MEDFORD AVE
Patchogue, NY 11772
(631) 475-5734
✔ PECOS✔ Accepts MedicareSame address
Rivkah Raza, D.O.
Family Practice
NPI 1063827384
130 MEDFORD AVE
Patchogue, NY 11772
(631) 475-5734
✔ PECOS✔ Accepts MedicareSame address
Simone Guest, D.O
Family Practice
NPI 1558598177
8 MAPLE AVE
Bay Shore, NY 11706
(631) 665-4392
✔ PECOS✔ Accepts Medicare13 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 33D0970811

Patchogue Family Medical Care PC · Patchogue, NY
Active · expires Jul 9, 2027
CLIA Number33D0970811
Laboratory TypePhysician Office
Certificate Effective DateJuly 10, 2025
Certificate Expiration DateJuly 9, 2027
Laboratory DirectorDr. Christine M. Doucet
Laboratory Phone(631) 475-5734
Laboratory LocationPatchogue Family Medical Care PC130 Medford Avenue, Patchogue, NY 11772
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Patchogue Family Medical Care, PC's NPI number?

The NPI number for Patchogue Family Medical Care, PC is 1700915113. It was assigned to this organization in the NPPES registry on March 2, 2007.

Where is Patchogue Family Medical Care, PC located?

Patchogue Family Medical Care, PC is located at 130 Medford Ave, Patchogue, NY 11772. The listed phone number is (631) 475-5734.

What is Patchogue Family Medical Care, PC's specialty?

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

Is Patchogue Family Medical Care, PC enrolled in Medicare?

Yes. Patchogue Family Medical Care, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Patchogue Family Medical Care, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Family Practice, reassign their Medicare billing to Patchogue Family Medical Care, PC. 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, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Patchogue Family Medical Care, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0970811) is associated with this NPI, valid through July 9, 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 Patchogue Family Medical Care, PC was last updated on March 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.