Shore to Shore Medical Wellness PLLC
NPI 1679211965 · Specialist · Port Jefferson Station, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shore to Shore Medical Wellness PLLC is a Specialist organization in Port Jefferson Station, NY (NPI 1679211965).
Provider details
- NPI number
- 1679211965
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Gregory Brevetti, Owner(917) 575-8907
Specialties & taxonomies
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
- 2022-05-25
- Last updated
- 2023-02-17
- Certified
- 2023-02-17
Frequently asked questions
- What is Shore to Shore Medical Wellness PLLC's NPI number?
- Shore to Shore Medical Wellness PLLC's National Provider Identifier (NPI) is 1679211965, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shore to Shore Medical Wellness PLLC?
- Shore to Shore Medical Wellness PLLC is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Shore to Shore Medical Wellness PLLC located?
- Shore to Shore Medical Wellness PLLC's practice location on file with NPPES is 1500 Route 112 Ste B, Port Jefferson Station, NY 11776-8055.
- What is Shore to Shore Medical Wellness PLLC's phone number?
- The practice phone number listed in the NPPES registry for Shore to Shore Medical Wellness PLLC is (631) 343-4184.
- Does Shore to Shore Medical Wellness PLLC accept Medicare?
- Shore to Shore Medical Wellness PLLC 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 Shore to Shore Medical Wellness PLLC?
- The authorized official listed on Shore to Shore Medical Wellness PLLC's NPPES record is Gregory Brevetti, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shore to Shore Medical Wellness PLLC's NPI active?
- Yes — Shore to Shore Medical Wellness PLLC's NPI (1679211965) is active in the NPPES registry as of the last update on 2023-02-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.