South Nassau Physician Practice PC
NPI 1962652685ActiveOrganization· Surgery· Valley Stream, NY
Surgery in Valley Stream, New York, registered in NPPES in September 2008. The authorized official on file is Rajiv V. Datta, MD, Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1962652685 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 30, 2008 |
| Last updated in NPPES | Sep 30, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | 201327 | NY |
| Surgery | 208600000X | 200879 | NY |
| Surgery | 208600000X | 242239 | NY |
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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