SOUTH SHORE MEDICAL CARE, PC
NPI 1861696171
Family Medicine in Deer Park, NY
About South Shore Medical Care, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH SHORE MEDICAL CARE, PC (NPI 1861696171) is a healthcare organization registered as a family medicine in Deer Park, New York and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through December 23, 2027 and lists Marc Albert Lewandoski, Doctor, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Shore Medical Care, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to South Shore Medical Care, PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 33D0994505
South Shore Medical Care PC · Deer Park, NYFrequently 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 South Shore Medical Care, PC's NPI number?
The NPI number for South Shore Medical Care, PC is 1861696171. It was assigned to this organization in the NPPES registry on June 12, 2007.
Where is South Shore Medical Care, PC located?
South Shore Medical Care, PC is located at 16 Van Cott Rd Suite 2E, Deer Park, NY 11729. The listed phone number is (631) 274-0777.
What is South Shore Medical Care, PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is South Shore Medical Care, PC enrolled in Medicare?
Yes. South Shore Medical Care, PC is registered in the Medicare PECOS enrollment system.
When is South Shore Medical Care, PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (New York, Physician - Unknown Physician Specialty) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through South Shore Medical Care, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to South Shore 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does South Shore Medical Care, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D0994505) is associated with this NPI, valid through December 23, 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 South Shore Medical Care, PC was last updated on January 10, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# South Shore Medical Care, Pc · NPI 1861696171
Family Medicine organization in Deer Park, New York. Organization record, active in the CMS NPPES registry since June 12, 2007.
## Identity
- **NPI:** 1861696171 (Entity type: Organization)
- **Enumerated:** June 12, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Marc Lewandoski, DOCTOR
## Practice location
- **Address:** 16 VAN COTT RD, SUITE 2E, Deer Park, NY 11729-6519
- **Phone:** (631) 274-0777 · **Fax:** (631) 274-9499
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (DME, New York, Physician - Unknown Physician Specialty) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 10, 2012
- **Other identifiers:** Medicare ID-Type Unspecified WEY021 (NY); Medicare UPIN H27968 (NY)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1861696171) · Data from the CMS NPPES public registry.