PORT MD MEDICAL WELLNESS
NPI 1912460791
Clinic/Center in Port Jefferson, NY

Q: What is Port Jefferson Surgical PC's NPI number?

The NPI number for Port Jefferson Surgical PC is 1912460791. It was assigned to this organization in the NPPES registry on April 9, 2019. The provider is doing business as Port MD Medical Wellness.

Q: What is Port Jefferson Surgical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since April 09, 2019

1227 MAIN ST STE 101, PORT JEFFERSON, NY 11777(718) 554-1042 Get Directions Write a Review

NPPES record last updated: October 1, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 1, 2019, Jul 25, 2019, Apr 9, 2019 (3 updates tracked since 2019).

On this page

About Port Md Medical Wellness NPPES

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

PORT MD MEDICAL WELLNESS (NPI 1912460791) is a healthcare organization registered as a clinic/center in Port Jefferson, New York and active in the NPI registry since April 2019. The organization lists Markella Christakis, Billing, as its authorized official.

NPPES Registry Identity

NPI1912460791

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NamePORT JEFFERSON SURGICAL PC

Location Address1227 MAIN ST STE 101Port Jefferson, NY 11777-2227

Mailing Address70 N Country Rd Ste 201Port Jefferson, NY 11777-2161

Phone(718) 554-1042

Organization SubpartNo

Authorized OfficialMarkella ChristakisBilling · (631) 403-4310

Enumeration DateApril 9, 2019

Last NPPES UpdateOctober 1, 20193 updates tracked since enumeration

✔ NPI 1912460791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

1227 MAIN ST STE 101, Port Jefferson, NY 11777

Open in Google Maps ↗

Other Names 1

Doing Business AsPort Md Medical Wellness

Other Providers at the Same Location NPPES

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

KELSEY LYNN MCNALLY MHC

Counselor (Mental Health)

1227 MAIN ST STE 101
PORT JEFFERSON, NY 11777

Suffolk County (631) 371-3825

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 Port Jefferson Surgical PC's NPI number?

The NPI number for Port Jefferson Surgical PC is 1912460791. It was assigned to this organization in the NPPES registry on April 9, 2019. The provider is doing business as Port MD Medical Wellness.

Where is Port Jefferson Surgical PC located?

Port Jefferson Surgical PC is located at 1227 Main St Ste 101, Port Jefferson, NY 11777. The listed phone number is (718) 554-1042.

What is Port Jefferson Surgical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Port Jefferson Surgical PC was last updated on October 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.