Individual provider Active NPI

Bryan Baracaldo, DPT

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1073120739
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
046008 Issued in NY
Practice address
1000 Northern Blvd
Great Neck, NY 11021-5338
Phone
(516) 466-9730
NPI assigned
Sep 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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 046008 NY Primary

Addresses

Primary practice location

1000 Northern Blvd
Great Neck, NY 11021-5338

Mailing address

800 E Gate Blvd
Garden City, NY 11530-2105
Phone (516) 745-8070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201110000622 NY Practitioner - Physical Therapist in Private Practice 5799195327 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anchor Health Homecare Services IncGroup PAC ID 2163802570, 96 clinicians

Practice addresses (Care Compare)

Brooklyn, NY 11206
Phone (718) 701-7300

Garden City, NY 11530
Phone (516) 745-8070

1101 Stewart Ave
Suite 100
Garden City, NY 11530-4833
Phone (516) 234-6158

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Dec 1, 2022 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Oct 1, 2020 Accepting new patients

Locations

2608 Merrick Rd
Bellmore, NY 11710
Phone (516) 730-2230

800 E Gate Blvd
Garden City, NY 11530

1101 Stewart Ave
Ste 100
Garden City, NY 11530
Phone (516) 234-6158

825 E Gate Blvd
Ste 100
Garden City, NY 11530
Phone (516) 227-5344

1000 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 466-4700

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

Organizations & group practices 4

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": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1073120739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E GATE BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302105",
            "telephone_number": "516-745-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NORTHERN BLVD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215338",
            "telephone_number": "516-466-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARACALDO",
        "first_name": "BRYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.