EAST NORTHPORT MEDICAL CARE PLLC
NPI 1932431103
Internal Medicine in East Northport, NY

Q: What is East Northport Medical Care PLLC's NPI number?

The NPI number for East Northport Medical Care PLLC is 1932431103. It was assigned to this organization in the NPPES registry on February 12, 2010.

Q: What is East Northport Medical Care PLLC's specialty?

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

Active since February 12, 2010CLIA 33D0697090 · Waiver

554 LARKFIELD RD, SUITE 101, EAST NORTHPORT, NY 11731(631) 368-9166(631) 368-5682 Get Directions Write a Review

NPPES record last updated: May 19, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About East Northport Medical Care Pllc NPPES

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

EAST NORTHPORT MEDICAL CARE PLLC (NPI 1932431103) is a healthcare organization registered as an internal medicine in East Northport, New York and active in the NPI registry since February 2010. The organization holds a CLIA Waiver certificate valid through December 5, 2026 and lists Anthony J Antonucci, Partner, as its authorized official.

NPPES Registry Identity

NPI1932431103

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameEAST NORTHPORT MEDICAL CARE PLLC

Location Address554 LARKFIELD RD, SUITE 101East Northport, NY 11731-4205

Mailing Address554 Larkfield Rd, Suite 101East Northport, NY 11731-4205 · (631) 368-9166 · Fax (631) 368-5682

Phone(631) 368-9166

Fax(631) 368-5682

Organization SubpartNo

Authorized OfficialAnthony J AntonucciPartner · (631) 368-9166

Enumeration DateFebruary 12, 2010

Last NPPES UpdateMay 19, 2010

✔ NPI 1932431103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NY · 170689

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.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 226879 (NY)

554 LARKFIELD RD, East Northport, NY 11731

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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 MULTIPLE 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)

East Northport Medical Care Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to East Northport Medical Care PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Amir Herman, D.O.

Family Practice

NPI 1306867494

554 LARKFIELD RD SUITE 101
East Northport, NY 11731

(631) 368-9166

✔ PECOS✔ Accepts MedicareSame address

Rose Ezeani, NP

Nurse Practitioner

NPI 1609921568

1111 MONTAUK HWY STE 2-4
West Islip, NY 11795

(631) 647-9100

✔ PECOS11 mi

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 33D0697090

East Northport Medical Care, PLLC · East Northport, NY

Active · expires Dec 5, 2026

CLIA Number33D0697090

Laboratory TypePhysician Office

Certificate Effective DateDecember 6, 2024

Certificate Expiration DateDecember 5, 2026

Laboratory DirectorDr. Amir Herman

Laboratory Phone(631) 368-9166

Laboratory LocationEast Northport Medical Care, PLLC554 Larkfield Road, Suite 101, East Northport, NY 11731

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 East Northport Medical Care PLLC's NPI number?

The NPI number for East Northport Medical Care PLLC is 1932431103. It was assigned to this organization in the NPPES registry on February 12, 2010.

Where is East Northport Medical Care PLLC located?

East Northport Medical Care PLLC is located at 554 Larkfield Rd Suite 101, East Northport, NY 11731. The listed phone number is (631) 368-9166.

What is East Northport Medical Care PLLC's specialty?

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

Is East Northport Medical Care PLLC enrolled in Medicare?

Yes. East Northport Medical Care PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through East Northport Medical Care PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to East Northport Medical Care PLLC, in Family Practice and Nurse Practitioner. 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, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does East Northport Medical Care PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0697090) is associated with this NPI, valid through December 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for East Northport Medical Care PLLC was last updated on May 19, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.