NPIMap

Organization Active NPI

Gold Coast Physical Therapist and Physical Therapy Assistant PLLC

Doing business as Gold Coast Physical Therapy and Sports Trainin

  • Physical Therapist
  • Commack, NY
National Provider Identifier
1033241302
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GOLD COAST PHYSICAL THERAPIST AND PHYSICAL THERAPY ASSISTANT PLLC
Doing business as
Gold Coast Physical Therapy and Sports Trainin
Practice address
5036 Jericho Tpke
Suite 301
Commack, NY 11725-2812
Phone
(631) 486-5286
Fax
(631) 486-5287
NPI assigned
Mar 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Donna Geraci
Title
Office Manager
Phone
(631) 486-5286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

5036 Jericho Tpke
Suite 301
Commack, NY 11725-2812

Mailing address

5036 Jericho Tpke
Suite 301
Commack, NY 11725-2812
Phone (631) 486-5286

Other names 1

  • Gold Coast Physical Therapy and Sports Trainin Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gold Coast Physical Therapy and Physcial Therapy Asst PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5036 Jericho Tpke
Ste 301
Commack, NY 11725
Phone (631) 486-5286

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033241302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 JERICHO TPKE",
            "address_2": "SUITE 301",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252812",
            "telephone_number": "631-486-5286",
            "fax_number": "631-486-5287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5036 JERICHO TPKE",
            "address_2": "SUITE 301",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252812",
            "telephone_number": "631-486-5286",
            "fax_number": "631-486-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST PHYSICAL THERAPIST AND PHYSICAL THERAPY ASSISTANT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GERACI",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "631-486-5286"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gold Coast Physical Therapy and Sports Trainin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.