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1717 Medical PC

Sports Medicine (Physical Medicine & Rehabilitation) Physician in Islandia, NY · enumerated 2023 · authorized official Jordan Sudberg, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1467134684

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Registry record

Entity type Organization (Type 2)
Legal business name 1717 Medical PC
Practice address 1717 Veterans Memorial Hwy Ste 1, Islandia, NY, 11749
Phone (631) 203-4300
Enumeration date Aug 7, 2023
Last updated in NPPES Aug 7, 2023

Taxonomy & classification

2081S0010X Sports Medicine (Physical Medicine & Rehabilitation) Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Jordan Sudberg
Title Owner
Phone (631) 482-2754

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for 1717 Medical PC?
The NPI for 1717 Medical PC is 1467134684, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for 1717 Medical PC?
NPPES lists Jordan Sudberg (Owner) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-08-07.