Active NPI
Pattianne Ruppel, P.T.
- Physical Therapist
- Port Jefferson, NY
National Provider Identifier
1083740096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 013482
- Practice address
- 200 Belle Terre Rd
Port Jefferson, NY 11777-1968 - Phone
- (631) 474-6111
- Fax
- (631) 474-6861
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 013482 | NY | Primary |
Addresses
Primary practice location
200 Belle Terre Rd
Port Jefferson, NY 11777-1968
Mailing address
34 Westwood LN
Kings Park, NY 11754-5121
Phone (631) 988-4895
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013482 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546300800000",
"number": "1083740096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 WESTWOOD LN",
"city": "KINGS PARK",
"state": "NY",
"postal_code": "117545121",
"telephone_number": "631-988-4895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 BELLE TERRE RD",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117771968",
"telephone_number": "631-474-6111",
"fax_number": "631-474-6861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUPPEL",
"first_name": "PATTIANNE",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2019-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "013482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.