Michael Gregory, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

004079 Issued in NY

Practice address

52 Route 25a
Smithtown, NY 11787-1346

Phone

(631) 862-3963

NPI assigned

Nov 5, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1053740431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FRANCIS ST",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331813",
            "telephone_number": "631-428-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 ROUTE 25A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871346",
            "telephone_number": "631-862-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "MICHAEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "004079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Gray
• Jenna Elise Graziano
• Terry Jane Greenberg, LCSW
• Francine Greene, LCSW-R
• Patrick Fritz Greger, PA-C
• Jennifer Anne Grella, APRN,BC
• Nina Gresser-Tacetta
• Joan R. Grilli, OTR/CHT
• Judith Helene Grodinsky, L.C.S.W.
• Holly Gross, DMD

• Physical Therapy Assistant in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.