Individual provider Active NPI

Robert Marder, MS, PT

  • Physical Therapist
  • East Meadow, NY
National Provider Identifier
1073508719
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021477-1 Issued in NY
Practice address
258 E Meadow Ave
Ste 3
East Meadow, NY 11554-2456
Phone
(516) 375-4320
NPI assigned
Sep 19, 2005
Last updated
Aug 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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 021477-1 NY Primary

Addresses

Primary practice location

258 E Meadow Ave
Ste 3
East Meadow, NY 11554-2456

Mailing address

12 Woodstork Dr
Mount Sinai, NY 11766-3400
Phone (516) 375-4320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060828000044 NY Practitioner - Physical Therapist in Private Practice 5597701516 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
Group practices
Optimum Therapeutics PT and OT PLLCGroup PAC ID 5991977712, 41 clinicians

Practice addresses (Care Compare)

1 Huntington Quadrangle
Suite 1S07
Melville, NY 11747-4426
Phone (516) 222-2010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021477-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert B Marder Physical Therapy PC CurrentSince Oct 1, 2014 Accepting new patients
Optimum Therapeutics PT & OT PLLC Physical Therapist CurrentSince Mar 1, 2011 Accepting new patients
Propel Physical Therapy PC Physical Therapist Past Accepting new patients

Locations

258 E Meadow Ave
Ste 3
East Meadow, NY 11554
Phone (516) 222-2010

1 Huntington Quadrangle
Ste 1S07
Melville, NY 11747
Phone (516) 222-2010

560 Broadhollow Rd
Ste 304
Melville, NY 11747
Phone (516) 222-2010

8 Roosevelt Ave
Port Jefferson Station, NY 11776
Phone (631) 736-7707

Organizations & group practices 5

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1073508719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WOODSTORK DR",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117663400",
            "telephone_number": "516-375-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 E MEADOW AVE",
            "address_2": "STE 3",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542456",
            "telephone_number": "516-375-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDER",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MS, PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021477-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.