Individual provider Active NPI

Jacob Kurian, MS,PT

  • Physical Therapist
  • Islandia, NY
National Provider Identifier
1063453538
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026465 Issued in NY
Practice address
183 Sunflower LN
Islandia, NY 11749-1616
Phone
(631) 630-9115
Fax
(516) 873-9522
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 026465 NY Primary

Addresses

Primary practice location

183 Sunflower LN
Islandia, NY 11749-1616

Mailing address

183 Sunflower LN
Islandia, NY 11749-1616
Phone (631) 630-9115

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070330000314 NY Practitioner - Physical Therapist in Private Practice 0547364507 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

Practice addresses (Care Compare)

137 Willis Ave
Suite 100
Mineola, NY 11501-2670
Phone (516) 833-5880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
026465NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Enhanced Physical Therapy PC Physical Therapist CurrentSince May 29, 2011 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist Past Accepting new patients

Locations

137 Willis Ave
Ste 100
Mineola, NY 11501
Phone (516) 741-9600

137 Willis Ave
Mineola, NY 11501
Phone (516) 741-8822

8611 Lefferts Blvd
Ste 3B
Richmond Hill, NY 11418
Phone (718) 581-5599

13104 Liberty Ave
South Richmond Hill, NY 11419
Phone (516) 587-0950

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063453538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 SUNFLOWER LN",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117491616",
            "telephone_number": "631-630-9115",
            "fax_number": "516-873-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 SUNFLOWER LN",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117491616",
            "telephone_number": "631-630-9115",
            "fax_number": "516-873-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURIAN",
        "first_name": "JACOB",
        "name_prefix": "Mr.",
        "credential": "MS,PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islandia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.