Individual provider Active NPI

Dale D Jabagat, PT

  • Physical Therapist
  • Huntington Station, NY
National Provider Identifier
1023229267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
019426-1 Issued in NY
Practice address
1705 New York Ave
Huntington Station, NY 11746-2444
Phone
(631) 424-5070
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 019426-1 NY Primary

Addresses

Primary practice location

1705 New York Ave
Huntington Station, NY 11746-2444

Mailing address

1705 New York Ave
Huntington Station, NY 11746-2444
Phone (631) 424-5070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140305001369 NY Practitioner - Physical Therapist in Private Practice 0648371641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esd PT OT and SLP PLLCGroup PAC ID 5991044125, 77 clinicians

Practice addresses (Care Compare)

2632 Atlantic Ave
Brooklyn, NY 11207-2425
Phone (718) 473-3808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019426-1NYMDPhysical Therapist
019426NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Esd PT OT & SLP PLLC Physical Therapist CurrentSince Aug 17, 2024 Accepting new patients

Locations

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

2632 Atlantic Ave
#13202
Brooklyn, NY 11207

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023229267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 NEW YORK AVE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117462444",
            "telephone_number": "631-424-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 NEW YORK AVE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117462444",
            "telephone_number": "631-424-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABAGAT",
        "first_name": "DALE",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "019426-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.