Port Jefferson Operating LLC
NPI 1093286585 · Skilled Nursing Facility · Port Jefferson, NY
Enrolled with Medicare as Part a Provider - Skilled Nursing Facility · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Port Jefferson Operating LLC is a Skilled Nursing Facility organization in Port Jefferson, NY (NPI 1093286585).
Provider details
- NPI number
- 1093286585
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Mark Friedman, Manager / Member(917) 596-1800
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Waters Edge Rehab & Nursing Center at Port Jefferson
Registry dates
- Enumerated
- 2018-12-10
- Last updated
- 2018-12-10
Frequently asked questions
- What is Port Jefferson Operating LLC's NPI number?
- Port Jefferson Operating LLC's National Provider Identifier (NPI) is 1093286585, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Port Jefferson Operating LLC?
- Port Jefferson Operating LLC is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is Port Jefferson Operating LLC located?
- Port Jefferson Operating LLC's practice location on file with NPPES is 150 Dark Hollow Rd, Port Jefferson, NY 11777-2048.
- What is Port Jefferson Operating LLC's phone number?
- The practice phone number listed in the NPPES registry for Port Jefferson Operating LLC is (631) 473-5400.
- Does Port Jefferson Operating LLC accept Medicare?
- Port Jefferson Operating LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Port Jefferson Operating LLC?
- The authorized official listed on Port Jefferson Operating LLC's NPPES record is Mark Friedman, Manager / Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Port Jefferson Operating LLC's NPI active?
- Yes — Port Jefferson Operating LLC's NPI (1093286585) is active in the NPPES registry as of the last update on 2018-12-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.