Organization Active NPI

RG Physical Therapy P.C.

  • Physical Therapist
  • Bay Shore, NY
National Provider Identifier
1043096803
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RG PHYSICAL THERAPY P.C.
Practice address
59 E. Main Street
Bayshore, NY 11706
Phone
(631) 447-2700
Fax
(631) 683-5661
NPI assigned
Sep 6, 2023
Last updated
Feb 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Authorized official

Name
Alie Moran
Title
Office Admin
Phone
(516) 406-2341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

59 E. Main Street
Bayshore, NY 11706

Mailing address

59 E. Main Street
Bayshore, NY 11706
Phone (631) 447-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250304000064 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1153842471 Receives reassigned benefits from 1 practitioner
Practice locations: Bay Shore, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1693958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1043096803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 E. MAIN STREET",
            "city": "BAYSHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-447-2700",
            "fax_number": "631-683-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 E. MAIN STREET",
            "city": "BAYSHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-447-2700",
            "fax_number": "631-683-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RG PHYSICAL THERAPY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-06",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "ALIE",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "516-406-2341"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.