Individual provider Active NPI

Vincent Lee, PT,DPT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1063390839
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054551 Issued in NY
Practice address
1243 Woodrow Rd BLDG Suite
Staten Island, NY 10309-1725
Phone
(718) 966-0111
NPI assigned
Aug 21, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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 054551 NY Primary

Addresses

Primary practice location

1243 Woodrow Rd BLDG Suite
Staten Island, NY 10309-1725

Mailing address

14 Impala CT BLDG Suite
Staten Island, NY 10305-3781
Phone (646) 712-1528

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250829002559 NY Practitioner - Physical Therapist in Private Practice 9133620230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RB Physical and Occupational Therapy, PLLCGroup PAC ID 5294870226, 312 clinicians

Practice addresses (Care Compare)

1243 Woodrow Rd
Suite 323
Staten Island, NY 10309-1725
Phone (718) 966-0111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054551NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Aug 21, 2025 Accepting new patients
One on One Physical Therapy Services PLLC Physical Therapist PastSince Aug 21, 2025 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

231 Beach 116th St
Rockaway Park, NY 11694
Phone (718) 474-2224

1243 Woodrow Rd
Ste 323
Staten Island, NY 10309
Phone (718) 966-0111

1243 Woodrow Rd
Staten Island, NY 10309
Phone (718) 390-0060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1063390839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 IMPALA CT BLDG SUITE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053781",
            "telephone_number": "646-712-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 WOODROW RD BLDG SUITE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091725",
            "telephone_number": "718-966-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "VINCENT",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.