Active Life Health of Ny PC
NPI 1275814105ActiveOrganization· General Practice· Smithtown, NY
General Practice in Smithtown, New York, registered in NPPES in September 2011. The authorized official on file is John J. Rush, MD, Owner. Enrolled in Medicare as dme supplier - physician - general practice and part b supplier - clinic/group practice.
Overview
| NPI | 1275814105 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 6, 2011 |
| Last updated in NPPES | Mar 4, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | 2611911 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - General Practice (NY); Part B Supplier - Clinic/Group Practice (NY) |
|---|
Other General Practice providers in Smithtown
- 1316168321
- 1659546901