Individual provider Active NPI

Anthony Simon

  • Physical Therapist
  • North Babylon, NY
National Provider Identifier
1023672912
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
044132-1 Issued in NY
Practice address
150 Bay Shore Rd
North Babylon, NY 11703-1711
Phone
(631) 586-6616
NPI assigned
Apr 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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 044132-1 NY Primary

Addresses

Primary practice location

150 Bay Shore Rd
North Babylon, NY 11703-1711

Mailing address

28 Lee Ave
Bethpage, NY 11714-3608

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190724001350 NY Practitioner - Physical Therapist in Private Practice 2961738232 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 Walt Whitman Rd
Suite 120
Melville, NY 11747-3237
Phone (631) 267-5130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
044132-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Feb 1, 2025 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Feb 1, 2025 Accepting new patients
Performax Physical Therapy Wellness, P.C. Physical Therapist CurrentSince Jul 16, 2019 Accepting new patients

Locations

1800 Walt Whitman Rd
Ste 120
Melville, NY 11747
Phone (631) 267-5130

150 Bay Shore Rd
North Babylon, NY 11703
Phone (631) 586-6616

Organizations & group practices 3

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": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1023672912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 LEE AVE",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BAY SHORE RD",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117031711",
            "telephone_number": "631-586-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044132-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.