Individual provider Active NPI

Todd Roberto, PT

  • Physical Therapist
  • Bayside, NY
National Provider Identifier
1033484324
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010383-1 Issued in NY
Practice address
22121 Corbett Rd
Bayside, NY 11361-2242
Phone
(718) 225-8667
NPI assigned
Mar 20, 2012
Last updated
Mar 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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 010383-1 NY Primary

Addresses

Primary practice location

22121 Corbett Rd
Bayside, NY 11361-2242

Mailing address

22121 Corbett Rd
Bayside, NY 11361-2242

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812006319 NY Practitioner - Physical Therapist in Private Practice 3779898317 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010383NYMDClinical Psychologist
010383-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Advantage Physical Therapy PC Physical Therapist CurrentSince Jun 28, 2015 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Jul 22, 2019 Accepting new patients
Hudson in Home Physical Therapy PLLC Physical Therapist CurrentSince Jul 15, 2019 Accepting new patients
Hudson in Home Physical Therapy and Occupational Therapy PLLC Physical Therapist PastSince Jan 4, 2022 Accepting new patients

Locations

800 E Gate Blvd
Garden City, NY 11530

1000 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 466-4700

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1033484324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22121 CORBETT RD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22121 CORBETT RD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612242",
            "telephone_number": "718-225-8667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTO",
        "first_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010383-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.

Verify at the official NPI Registry.