Active NPI
Judy A Hermann, MSPT
- Physical Therapist
- South Jamesport, NY
National Provider Identifier
1013192780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 022273-1
- Practice address
- 6 Sixth St
South Jamesport, NY 11970-0742 - Phone
- (631) 722-5677
- NPI assigned
- Dec 31, 2007
- Last updated
- Dec 31, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 022273-1 | NY | Primary |
Addresses
Primary practice location
6 Sixth St
South Jamesport, NY 11970-0742
Mailing address
PO Box 742
Jamesport, NY 11947-0742
Phone (631) 722-5677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080123000527 | NY | Practitioner - Physical Therapist in Private Practice | 8325120850 | Practice locations: South Jamesport, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022273-1 | NY | MD | Physical Therapist |
| 022273 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evolution Home Physical Therapy, P.C. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Port Jefferson, NY
- NPI 1477564599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199059200000",
"number": "1013192780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 742",
"city": "JAMESPORT",
"state": "NY",
"postal_code": "119470742",
"telephone_number": "631-722-5677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 SIXTH ST",
"city": "SOUTH JAMESPORT",
"state": "NY",
"postal_code": "119700742",
"telephone_number": "631-722-5677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMANN",
"first_name": "JUDY",
"middle_name": "A",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-31",
"last_updated": "2007-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "022273-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.