South Nassau Physicians PC
NPI 1104200641ActiveOrganization· Surgery· Valley Stream, NY
Surgery in Valley Stream, New York, registered in NPPES in July 2015. The authorized official on file is Mark Bogen, Cfo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1104200641 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 15, 2015 |
| Last updated in NPPES | Jul 15, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|
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