MEDICARE: CONSISTENT MSO, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1609668573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONSISTENT MSO, LLC

Provider Business Mailing Address
First Line	:	34 TOTTEN PL
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-2810
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	34 TOTTEN PL
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-2810
Country	:	US
Telephone Number	:	631-975-2033
Fax Number	:

Authorized Official
Title or Position	:	PRINCIPLE
Name	:	MR. PATRICK W. NOLAN
Credential	:
Telephone Number	:	631-975-2033

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	12/09/2025

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