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SUPREME MEDICAL P.C.
NPI 1902965171
Internal Medicine in East Setauket, NY

Active since December 06, 2006
100 N BELLE MEAD RD, SUITE D, EAST SETAUKET, NY 11733(631) 751-8905(631) 751-8908 Get Directions Write a Review

NPPES record last updated: March 3, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Supreme Medical P.c. NPPES

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

SUPREME MEDICAL P.C. (NPI 1902965171) is a healthcare organization registered as an internal medicine in East Setauket, New York and active in the NPI registry since December 2006. The organization lists Anjani Venkata Kota, President, as its authorized official.

NPPES Registry Identity

NPI1902965171
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSUPREME MEDICAL P.C.
Location Address100 N BELLE MEAD RD, SUITE DEast Setauket, NY 11733-3530
Mailing Address100 N Belle Mead Rd, Suite DEast Setauket, NY 11733-3530 · (631) 751-8905 · Fax (631) 751-8908
Phone(631) 751-8905
Fax(631) 751-8908
Organization SubpartNo
Authorized OfficialAnjani Venkata KotaPresident · (631) 751-8905
Enumeration DateDecember 6, 2006
Last NPPES UpdateMarch 3, 2014
✔ NPI 1902965171 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 · 222728
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.
100 N BELLE MEAD RD, East Setauket, NY 11733
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Other Identifiers 2

Medicare ID-Type Unspecified021AQ2NY
Medicare UPINH91854NY

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)

Supreme Medical P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Supreme Medical P.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

Anjani Kota, M.D.
Internal Medicine
NPI 1720055353
100 N BELLE MEAD AVE STE D
East Setauket, NY 11733
(631) 751-8905
✔ PECOS✔ Accepts MedicareSame address

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 Supreme Medical P.C.'s NPI number?

The NPI number for Supreme Medical P.C. is 1902965171. It was assigned to this organization in the NPPES registry on December 6, 2006.

Where is Supreme Medical P.C. located?

Supreme Medical P.C. is located at 100 N Belle Mead Rd Suite D, East Setauket, NY 11733. The listed phone number is (631) 751-8905.

What is Supreme Medical P.C.'s specialty?

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

Is Supreme Medical P.C. enrolled in Medicare?

Yes. Supreme Medical P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Supreme Medical P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Supreme Medical P.C.. 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.

When was this NPI record last updated?

The NPPES record for Supreme Medical P.C. was last updated on March 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.