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BACK AND NECK PAIN CENTER
NPI 1922486182
Physical Medicine & Rehabilitation - Pain Medicine in Port Jefferson, NY

Active since May 08, 2015
75 N COUNTRY RD, PORT JEFFERSON, NY 11777(631) 473-1320(631) 686-7972 Get Directions Write a Review

NPPES record last updated: May 8, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Back And Neck Pain Center NPPES

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

BACK AND NECK PAIN CENTER (NPI 1922486182) is a healthcare organization registered as a pain medicine in Port Jefferson, New York and active in the NPI registry since May 2015. The organization lists Sharon Donnelly, Project Director, as its authorized official.

NPPES Registry Identity

NPI1922486182
Entity TypeOrganization
Primary Taxonomy2081P2900X
Legal Business NameJOHN T MATHER MEMORIAL HOSPITAL
Location Address75 N COUNTRY RDPort Jefferson, NY 11777-2119
Mailing Address75 N Country RdPort Jefferson, NY 11777-2119 · (631) 473-1320 · Fax (631) 686-7972
Phone(631) 473-1320
Fax(631) 686-7972
Organization SubpartNo
Authorized OfficialSharon DonnellyProject Director · (631) 473-1320
Enumeration DateMay 8, 2015
✔ NPI 1922486182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081P2900X
Definition
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
75 N COUNTRY RD, Port Jefferson, NY 11777
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Other Names 1

Other NameBack And Neck Pain Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Back And Neck Pain Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Back And Neck Pain Center, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Katlyn Conville, NP
Nurse Practitioner
NPI 1023679503
75 N COUNTRY RD
Port Jefferson, NY 11777
(631) 686-2565
✔ PECOS✔ Accepts MedicareSame address
Patricia Dodd, N.P.
Nurse Practitioner
NPI 1821495086
75 N COUNTRY RD
Port Jefferson, NY 11777
(631) 476-2734
✔ PECOS✔ Accepts MedicareSame address
Theresa Grimes, FNP-BC
Nurse Practitioner
NPI 1912910910
75 N COUNTRY RD
Port Jefferson, NY 11777
(631) 476-2847
✔ PECOSSame address
Darlene Mcday, AGNP-C
Nurse Practitioner
NPI 1932497195
75 N COUNTRY RD
Port Jefferson, NY 11777
(631) 473-1320
✔ PECOSSame address
Heidi Schrader, NP
Nurse Practitioner
NPI 1972254290
75 N COUNTRY RD
Port Jefferson, NY 11777
(631) 275-3589
✔ PECOSSame address
Kristen Durkin, RN, ANP
Nurse Practitioner
NPI 1194107961
5316 NESCONSET HWY
Port Jefferson Station, NY 11776
(631) 474-0707
✔ PECOS✔ Accepts Medicare1.0 mi
Dorothy Raczkowski
Nurse Practitioner
NPI 1427571595
2714 172ND ST
Flushing, NY 11358
(646) 238-1302
✔ PECOS✔ Accepts Medicare40 mi
Alain Neri, NP
Nurse Practitioner
NPI 1063787760
7901 BROADWAY
Elmhurst, NY 11373
(718) 334-2460
✔ PECOS✔ Accepts Medicare46 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 John T Mather Memorial Hospital's NPI number?

The NPI number for John T Mather Memorial Hospital is 1922486182. It was assigned to this organization in the NPPES registry on May 8, 2015. The provider is also known as Back And Neck Pain Center.

Where is John T Mather Memorial Hospital located?

John T Mather Memorial Hospital is located at 75 N Country Rd, Port Jefferson, NY 11777. The listed phone number is (631) 473-1320.

What is John T Mather Memorial Hospital's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

Is John T Mather Memorial Hospital enrolled in Medicare?

Yes. John T Mather Memorial Hospital is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through John T Mather Memorial Hospital?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians, all in Nurse Practitioner, reassign their Medicare billing to John T Mather Memorial Hospital. 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, 5 practice at this address and 6 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 John T Mather Memorial Hospital was last updated on May 8, 2015. 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.