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SOUTH SHORE MEDICAL CARE, PC
NPI 1861696171
Family Medicine in Deer Park, NY

Active since June 12, 2007CLIA 33D0994505 · Waiver
16 VAN COTT RD, SUITE 2E, DEER PARK, NY 11729(631) 274-0777(631) 274-9499 Get Directions Write a Review

NPPES record last updated: January 10, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1861696171
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTH SHORE MEDICAL CARE, PC
Location Address16 VAN COTT RD, SUITE 2EDeer Park, NY 11729-6519
Mailing Address16 Van Cott Rd, Suite 2eDeer Park, NY 11729-6519 · (631) 274-0777 · Fax (631) 274-9499
Phone(631) 274-0777
Fax(631) 274-9499
Organization SubpartNo
Authorized OfficialMarc Albert LewandoskiDoctor · (631) 274-0777
Enumeration DateJune 12, 2007
Last NPPES UpdateJanuary 10, 2012
✔ NPI 1861696171 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 · 21762
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.
16 VAN COTT RD, Deer Park, NY 11729
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Other Identifiers 2

Medicare ID-Type UnspecifiedWEY021NY
Medicare UPINH27968NY

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

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, NY
Active · expires Dec 23, 2027
CLIA Number33D0994505
Laboratory TypePhysician Office
Certificate Effective DateDecember 24, 2025
Certificate Expiration DateDecember 23, 2027
Laboratory DirectorMarc Lewandoski Do
Laboratory Phone(631) 274-0777
Laboratory LocationSouth Shore Medical Care PC16 Van Cott Road, Deer Park, NY 11729
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

DAVID MOISAN PA
Physician Assistant
16 VAN COTT RD
DEER PARK, NY 11729
Suffolk County (631) 274-0777
DR. KERRY J SAUER DDS
Dentist
16 VAN COTT RD, SUITE 1W
DEER PARK, NY 11729
Suffolk County (631) 242-5329
TAHNEEMARIE LOUISE ROBERTS PA-C
Physician Assistant (Medical)
16 VAN COTT RD
DEER PARK, NY 11729
Suffolk County (631) 274-0777
DR. MARC ALBERT LEWANDOSKI DO
Family Medicine
16 VAN COTT RD, SUITE 2E
DEER PARK, NY 11729
Suffolk County (631) 274-0777
DR. ARTHUR WARREN KUPPERMAN D.M.D.
Dentist (Oral and Maxillofacial Surgery)
16 VAN COTT RD
DEER PARK, NY 11729
Suffolk County (631) 242-8388

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 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.

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.