Individual provider Active NPI

Rommel Lim Milliam, RPT

  • Physical Therapist
  • Middletown, NY
National Provider Identifier
1053746701
Registry record updated May 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
019050-1 Issued in NY
Practice address
42 Rykowski LN
Middletown, NY 10941-4018
Phone
(845) 673-5554
Fax
(845) 673-5760
NPI assigned
Sep 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2018

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 019050-1 NY Primary

Addresses

Primary practice location

42 Rykowski LN
Middletown, NY 10941-4018

Mailing address

11 Milo Dr
Middletown, NY 10941-2037
Phone (845) 800-8795

Other practice location 1

11 Milo Dr
Middletown, NY 10941-2037
Phone (845) 977-7531

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050601000061 NY Practitioner - Physical Therapist in Private Practice 6204878291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

42 Rykowski LN
Middleton, NY 10941-4018
Phone (845) 673-5554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019050-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Dec 1, 2017 Accepting new patients
Middletown Health Wellness Chiropractic PC PastSince Feb 18, 2024 Accepting new patients

Locations

16 Sumner Pl
Brooklyn, NY 11206
Phone (718) 336-9500

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1053746701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MILO DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109412037",
            "telephone_number": "845-800-8795",
            "fax_number": "845-673-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 RYKOWSKI LN",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414018",
            "telephone_number": "845-673-5554",
            "fax_number": "845-673-5760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Milo Dr",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "109412037",
            "country_code": "US",
            "telephone_number": "845-977-7531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLIAM",
        "first_name": "ROMMEL",
        "middle_name": "LIM",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-12",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "019050-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; 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.