South Nassau Physicians PC
NPI 1104200641 · Surgery Physician · Valley Stream, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
South Nassau Physicians PC is a Surgery Physician organization in Valley Stream, NY (NPI 1104200641).
Provider details
- NPI number
- 1104200641
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mark Bogen, Cfo(516) 632-3965
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
Registry dates
- Enumerated
- 2015-07-15
- Last updated
- 2015-07-15
Frequently asked questions
- What is South Nassau Physicians PC's NPI number?
- South Nassau Physicians PC's National Provider Identifier (NPI) is 1104200641, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is South Nassau Physicians PC?
- South Nassau Physicians PC is classified in the NPPES registry as Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is South Nassau Physicians PC located?
- South Nassau Physicians PC's practice location on file with NPPES is 1 S Central Ave, Valley Stream, NY 11580-5443.
- What is South Nassau Physicians PC's phone number?
- The practice phone number listed in the NPPES registry for South Nassau Physicians PC is (516) 632-3350.
- Does South Nassau Physicians PC accept Medicare?
- South Nassau Physicians PC 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 South Nassau Physicians PC?
- The authorized official listed on South Nassau Physicians PC's NPPES record is Mark Bogen, Cfo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is South Nassau Physicians PC's NPI active?
- Yes — South Nassau Physicians PC's NPI (1104200641) is active in the NPPES registry as of the last update on 2015-07-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.