Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Massa

Individual provider Physician Assistant · NPI 1942062302

Jack Massa is a Physician Assistant in Bay Shore, New York. Qualified in 2024, 2 years ago. Practices with Stony Brook Surgical Associates University Faculty Practice Corporati, a 102-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024

Practice location Address checks out

301 E Main St
Bay Shore, NY 11706-8408
Phone: (631) 968-3000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1942062302
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 30, 2024
Last updated in NPPESJanuary 30, 2024
Certification dateJanuary 30, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Stony Brook Surgical Associates University Faculty Practice Corporati — 102 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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