SOUTH NASSAU PHYSICIAN PRACTICE PC
NPI 1962652685
Surgery in Valley Stream, NY
About South Nassau Physician Practice Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH NASSAU PHYSICIAN PRACTICE PC (NPI 1962652685) is a healthcare organization registered as a surgery in Valley Stream, New York and active in the NPI registry since September 2008. The organization lists Rajiv V Datta, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Nassau Physician Practice Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
25Medicare enrollment records show 25 clinicians reassign Medicare billing to South Nassau Physician Practice PC, which bills Medicare for the services they deliver. Of these, 19 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 12
Nearest to this location (20)
See all 25Source: 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 Nassau Physician Practice PC's NPI number?
The NPI number for South Nassau Physician Practice PC is 1962652685. It was assigned to this organization in the NPPES registry on September 30, 2008.
Where is South Nassau Physician Practice PC located?
South Nassau Physician Practice PC is located at 1 S Central Ave, Valley Stream, NY 11580. The listed phone number is (516) 632-3350.
What is South Nassau Physician Practice PC's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is South Nassau Physician Practice PC enrolled in Medicare?
Yes. South Nassau Physician Practice PC is registered in the Medicare PECOS enrollment system.
When is South Nassau Physician Practice PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through South Nassau Physician Practice PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 25 clinicians in 12 Medicare specialties reassign their Medicare billing to South Nassau Physician Practice PC. 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. The largest specialties are Obstetrics/Gynecology (6), General Surgery (5) and Emergency Medicine (3). Of these, 19 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does South Nassau Physician Practice PC accept?
Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list South Nassau Physician Practice PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for South Nassau Physician Practice PC was last updated on September 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# South Nassau Physician Practice Pc · NPI 1962652685
Surgery organization in Valley Stream, New York. Organization record, active in the CMS NPPES registry since September 30, 2008.
## Identity
- **NPI:** 1962652685 (Entity type: Organization)
- **Enumerated:** September 30, 2008
- **Primary specialty:** Surgery · taxonomy 208600000X
- **Organization subpart:** No
- **Authorized official:** Rajiv Datta, DIRECTOR
## Practice location
- **Address:** 1 S CENTRAL AVE, Valley Stream, NY 11580-5443
- **Phone:** (516) 632-3350 · **Fax:** (516) 632-3355
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 25 clinicians in 12 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Obstetrics/Gynecology (6), General Surgery (5), Emergency Medicine (3); 19 practice within 10 miles; [full list](https://npiprofile.com/npi/1962652685/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 30, 2008
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Source: [NPI Profile](https://npiprofile.com/npi/1962652685) · Data from the CMS NPPES public registry.