Active Life Health of Ny PC
NPI 1275814105 · General Practice Physician · Smithtown, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Active Life Health of Ny PC is a General Practice Physician organization in Smithtown, NY (NPI 1275814105).
Provider details
- NPI number
- 1275814105
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- John Rush, Owner(301) 928-1697
- License
- 2611911 (TX)
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
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
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
Additional practice locations (2)
- 57 W 57th St Ste 1603New York, NY 10019-2833Phone: (631) 656-8796Fax: (631) 333-7322
- 363 Route 111Ste 107-BSmithtown, NY 11787-4756Phone: (631) 656-5544Fax: (631) 656-5545
Registry dates
- Enumerated
- 2011-09-06
- Last updated
- 2019-03-04
Frequently asked questions
- What is Active Life Health of Ny PC's NPI number?
- Active Life Health of Ny PC's National Provider Identifier (NPI) is 1275814105, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Active Life Health of Ny PC?
- Active Life Health of Ny PC is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Active Life Health of Ny PC located?
- Active Life Health of Ny PC's practice location on file with NPPES is 300 E Main St Ste 1, Smithtown, NY 11787-2900.
- What is Active Life Health of Ny PC's phone number?
- The practice phone number listed in the NPPES registry for Active Life Health of Ny PC is (631) 656-8796.
- Does Active Life Health of Ny PC accept Medicare?
- Active Life Health of Ny 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 Active Life Health of Ny PC?
- The authorized official listed on Active Life Health of Ny PC's NPPES record is John Rush, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Active Life Health of Ny PC's NPI active?
- Yes — Active Life Health of Ny PC's NPI (1275814105) is active in the NPPES registry as of the last update on 2019-03-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.