Individual provider Active NPI

Jared A. Kipnis, PT, DPT, COMT

  • Physical Therapist
  • Rockville Centre, NY
National Provider Identifier
1023288636
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028738-1 Issued in NY
Practice address
30 Hempstead Ave
Suite 258
Rockville Centre, NY 11570-4033
Phone
(516) 536-3800
Fax
(516) 536-4588
NPI assigned
Mar 11, 2008
Last updated
Aug 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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 028738-1 NY Primary

Addresses

Primary practice location

30 Hempstead Ave
Suite 258
Rockville Centre, NY 11570-4033

Mailing address

30 Hempstead Ave
Suite 258
Rockville Centre, NY 11570-4033
Phone (516) 536-3800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080520000901 NY Practitioner - Physical Therapist in Private Practice 9830268572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9525 Queens Blvd
Suite 3D
Rego Park, NY 11374-4510
Phone (718) 925-6212

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028738-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jan 1, 2022 Accepting new patients
True North Medical Group PC Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients
True North Medical Group PC CurrentSince Jan 1, 2018 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients

Locations

1101 Stewart Ave
Ste 100
Garden City, NY 11530
Phone (516) 234-6158

1728 Sunrise Hwy
Merrick, NY 11566
Phone (516) 992-4700

1983 Marcus Ave
Ste 119
New Hyde Park, NY 11042
Phone (516) 321-7526

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1023288636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HEMPSTEAD AVE",
            "address_2": "SUITE 258",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704033",
            "telephone_number": "516-536-3800",
            "fax_number": "516-536-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HEMPSTEAD AVE",
            "address_2": "SUITE 258",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704033",
            "telephone_number": "516-536-3800",
            "fax_number": "516-536-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPNIS",
        "first_name": "JARED",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, COMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-11",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028738-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.