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SUFFOLK MEDICAL SPECIALIST, PLLC
NPI 1710950688
Internal Medicine in Port Jefferson Station, NY

Active since February 09, 2006
1110 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776(631) 476-9100(631) 476-4919 Get Directions Write a Review

NPPES record last updated: December 12, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Suffolk Medical Specialist, Pllc NPPES

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

SUFFOLK MEDICAL SPECIALIST, PLLC (NPI 1710950688) is a healthcare organization registered as an internal medicine in Port Jefferson Station, New York and active in the NPI registry since February 2006. The organization lists Norman R Bennett, Owner, as its authorized official.

NPPES Registry Identity

NPI1710950688
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSUFFOLK MEDICAL SPECIALIST, PLLC
Location Address1110 HALLOCK AVEPort Jefferson Station, NY 11776-1210
Mailing Address1110 Hallock AvePort Jefferson Station, NY 11776-1210 · (631) 476-9100 · Fax (631) 476-4919
Phone(631) 476-9100
Fax(631) 476-4919
Organization SubpartNo
Authorized OfficialNorman R BennettOwner · (631) 476-9100
Enumeration DateFebruary 9, 2006
Last NPPES UpdateDecember 12, 2014
✔ NPI 1710950688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 159940
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1110 HALLOCK AVE, Port Jefferson Station, NY 11776
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Other Identifiers 2

Medicare PINWEK691
Medicare UPING19165

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)

Suffolk Medical Specialist, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Suffolk Medical Specialist, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Norman Bennett, M.D.
Internal Medicine
NPI 1700857786
620 BELLE TERRE RD STE 2
Port Jefferson, NY 11777
(631) 524-5960
✔ PECOS✔ Accepts Medicare1.0 mi
Kelly Godberson, NP
Nurse Practitioner
NPI 1053833962
3115 HORSEBLOCK RD
Medford, NY 11763
(631) 730-3000
✔ PECOS7.9 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 Suffolk Medical Specialist, PLLC's NPI number?

The NPI number for Suffolk Medical Specialist, PLLC is 1710950688. It was assigned to this organization in the NPPES registry on February 9, 2006.

Where is Suffolk Medical Specialist, PLLC located?

Suffolk Medical Specialist, PLLC is located at 1110 Hallock Ave, Port Jefferson Station, NY 11776. The listed phone number is (631) 476-9100.

What is Suffolk Medical Specialist, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Suffolk Medical Specialist, PLLC enrolled in Medicare?

Yes. Suffolk Medical Specialist, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Suffolk Medical Specialist, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Suffolk Medical Specialist, PLLC, in Internal Medicine and Nurse Practitioner. 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, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Suffolk Medical Specialist, PLLC was last updated on December 12, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.