Individual provider Active NPI

Kristen Marie Guleksen Al-Sullami, MSPT

  • Physical Therapist
  • Syosset, NY
National Provider Identifier
1043272701
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
022061-1 Issued in NY
Practice address
68651 Jericho Tpke
Ste 235
Syosset, NY 11791
Phone
(516) 682-8560
Fax
(516) 682-8562
NPI assigned
Apr 6, 2006
Last updated
Jul 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 022061 NY
Physical Therapist 225100000X 022061-1 NY Primary

Addresses

Primary practice location

68651 Jericho Tpke
Ste 235
Syosset, NY 11791

Mailing address

6851 Jericho Tpke
Ste. 235
Syosset, NY 11791
Phone (516) 682-8560

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110819000537 NY Practitioner - Physical Therapist in Private Practice 0941470447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision Physical Therapy LLCGroup PAC ID 4385535731, 2 clinicians

Practice addresses (Care Compare)

140 Eileen Way
Suite 700
Syosset, NY 11791-5330
Phone (516) 682-8560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022061-1NYMDPhysical Therapist
022061NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Physical Therapy, LLC Physical Therapist CurrentSince Jun 6, 2011 Accepting new patients
Sherrie Glasser, Physical Therapist. PC Physical Therapist Past Accepting new patients

Locations

140 Eileen Way
Ste 700
Syosset, NY 11791
Phone (516) 682-8560

Organizations & group practices 2

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1043272701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6851 JERICHO TPKE",
            "address_2": "STE. 235",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "516-682-8560",
            "fax_number": "516-682-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68651 JERICHO TPKE",
            "address_2": "STE 235",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "516-682-8560",
            "fax_number": "516-682-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULEKSEN AL-SULLAMI",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022061",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022061-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.