120 NEW YORK AVE SURGICAL PC — NPI 1891355301 (Licensed & Credentialed Allopathic & Osteopathic Physicians

CMS-1500 Box 24J / 33a • NPI

1891355301

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

208200000X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery

Box 32 Service Location & ZIP+4

120 NEW YORK AVE, HUNTINGTON, NY, 11743-2743

✓ 9-Digit EDI 837 ZIP+4 (11743-2743)

Practice Phone & Referral Fax

(631) 827-8159

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1891355301 (120 NEW YORK AVE SURGICAL PC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1891355301` (NPI-2 Organization / Facility)
Provider / Legal Name	120 NEW YORK AVE SURGICAL PC
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery NUCC Code: `208200000X` (Plastic Surgery)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	120 NEW YORK AVE, HUNTINGTON, NY, 11743-2743
Practice Telephone / Fax	Tel: (631) 827-8159
Administrative Mailing Address	120 NEW YORK AVE, HUNTINGTON, NY, 11743-2743
Enumeration & Last Sync	Enumerated: 2019-06-17 \| CMS Record Updated: 2019-06-17
Authorized Official	MATHEW JAMES (PATIENT ACCOUNTS)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

120 NEW YORK AVE, HUNTINGTON, NY, 11743-2743

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Plain-English Taxonomy & CMS Crosswalk (208200000X)

What Does Taxonomy Code 208200000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208200000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 24 (Physician/Plastic and Reconstructive Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Plastic Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (120 NEW YORK AVE SURGICAL PC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208200000X` — Plastic Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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120 NEW YORK AVE SURGICAL PC (NPI #1891355301)