Active NPI
Scott Irwin, P.T.
- Physical Therapist
- Commack, NY
National Provider Identifier
1053515312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14649
- Practice address
- 152 Veterans Memorial Hwy
Commack, NY 11725-3634 - Phone
- (631) 543-1614
- Fax
- (631) 543-1615
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14649 | NY | Primary |
Addresses
Primary practice location
152 Veterans Memorial Hwy
Commack, NY 11725-3634
Mailing address
28 Dolphin Rd
East Quogue, NY 11942-4907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14649 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317600000000",
"number": "1053515312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 DOLPHIN RD",
"city": "EAST QUOGUE",
"state": "NY",
"postal_code": "119424907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 VETERANS MEMORIAL HWY",
"city": "COMMACK",
"state": "NY",
"postal_code": "117253634",
"telephone_number": "631-543-1614",
"fax_number": "631-543-1615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRWIN",
"first_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2011-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "14649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.