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SOUTH SHORE COLLABORATIVE PSYCHIATRY NP PLLC
NPI 1942882246
Nurse Practitioner - Psychiatric/Mental Health in Amityville, NY

Active since April 26, 2021
167 BROADWAY, AMITYVILLE, NY 11701(631) 317-9480(231) 216-7467 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 12, 2025, Apr 26, 2021 (2 updates tracked since 2021).

About South Shore Collaborative Psychiatry Np Pllc NPPES

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

SOUTH SHORE COLLABORATIVE PSYCHIATRY NP PLLC (NPI 1942882246) is a healthcare organization registered as a psychiatric/mental health in Amityville, New York and active in the NPI registry since April 2021. The organization maintains a secondary practice location in East Islip and lists Samantha Roche, Pmhnp-bc, as its authorized official.

NPPES Registry Identity

NPI1942882246
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameSOUTH SHORE COLLABORATIVE PSYCHIATRY NP PLLC
Location Address167 BROADWAYAmityville, NY 11701-2782
Mailing Address167 BroadwayAmityville, NY 11701-2782 · (631) 317-9480 · Fax (231) 216-7467
Phone(631) 317-9480
Fax(231) 216-7467
Organization SubpartNo
Authorized OfficialSamantha RochePmhnp-bc · (631) 317-9480
Enumeration DateApril 26, 2021
Last NPPES UpdateJuly 25, 20252 updates tracked since enumeration
NPPES CertifiedJuly 25, 2025
✔ NPI 1942882246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
167 BROADWAY, Amityville, NY 11701
Open in Google Maps ↗

Secondary Practice Location 1

Location 1200 Carleton AveEast Islip, NY 11730-1222 · Phone (631) 317-9480

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)

South Shore Collaborative Psychiatry Np Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to South Shore Collaborative Psychiatry Np 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)

Samantha Roche, PMHNP-BC
Nurse Practitioner
NPI 1609277268
167 BROADWAY
Amityville, NY 11701
(631) 317-9480
✔ PECOS✔ Accepts MedicareSame address
Sharon Friedman-Urevich, MSN,RN,FNP-C, PMHNP
Nurse Practitioner
NPI 1134182447
534 2ND ST
East Northport, NY 11731
(516) 852-7974
✔ PECOS14 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 South Shore Collaborative Psychiatry Np PLLC's NPI number?

The NPI number for South Shore Collaborative Psychiatry Np PLLC is 1942882246. It was assigned to this organization in the NPPES registry on April 26, 2021.

Where is South Shore Collaborative Psychiatry Np PLLC located?

South Shore Collaborative Psychiatry Np PLLC is located at 167 Broadway, Amityville, NY 11701. The listed phone number is (631) 317-9480.

What is South Shore Collaborative Psychiatry Np PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is South Shore Collaborative Psychiatry Np PLLC enrolled in Medicare?

Yes. South Shore Collaborative Psychiatry Np PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through South Shore Collaborative Psychiatry Np PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to South Shore Collaborative Psychiatry Np PLLC. 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.

When was this NPI record last updated?

The NPPES record for South Shore Collaborative Psychiatry Np PLLC was last updated on July 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.