Individual provider Active NPI

Stephen Michael Joseph, MA, PT, ATC, CSCS

  • Physical Therapist
  • Holbrook, NY
National Provider Identifier
1063497717
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
016663 Issued in NY
Practice address
20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616
Phone
(631) 467-3700
Fax
(631) 467-0928
NPI assigned
Dec 14, 2005
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 016663 NY
Sports Physical Therapist 2251S0007X 016663 NY
Orthopedic Physical Therapist 2251X0800X 016663 NY
Physical Therapist 225100000X 016663 NY Primary

Addresses

Primary practice location

20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616

Mailing address

20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616
Phone (631) 467-3700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040311000430 NY Practitioner - Physical Therapist in Private Practice 9133018955 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Holbrook, NY 11741
Phone (631) 866-6507

1548 Carl Ave
Holbrook, NY 11741-2318

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016663NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Jan 1, 2017 Accepting new patients
Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Advantagecare Physicians PC CurrentSince Jan 1, 2017 Accepting new patients
Speonk Physical Therapy Physical Therapist CurrentSince Nov 11, 2024 Accepting new patients
Physical Therapy Associates of Smithtown PC Physical Therapist CurrentSince Nov 11, 2024 Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist Past Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

14015 Sanford Ave
Flushing, NY 11355
Phone (718) 670-6400

9610 Metropolitan Ave
Forest Hills, NY 11375
Phone (718) 459-0400

100 Maple Ave
Smithtown, NY 11787
Phone (631) 265-7671

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1063497717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-467-3700",
            "fax_number": "631-467-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-467-3700",
            "fax_number": "631-467-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MA, PT, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "016663",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NY",
            "license": "016663",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "016663",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.