NPIMap

Organization Active NPI

Professional Orthopedic and Sports Physical Therapy, PC

  • Physical Therapist
  • Stony Brook, NY
National Provider Identifier
1093160590
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, PC
Practice address
1 Chapman Pkwy
Stony Brook, NY 11790-1756
Phone
(718) 819-6805
Fax
(347) 841-9109
NPI assigned
May 3, 2016
Last updated
May 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Authorized official

Name
Kathleen Brush
Title
Credentialing Manager
Phone
(718) 819-6805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1 Chapman Pkwy
Stony Brook, NY 11790-1756

Mailing address

2142 Utopia Pkwy
Whitestone, NY 11357-4142
Phone (718) 819-6805

National Provider Directory

National Provider Directory
Tax ID family
Professional Orthopedic Sports PT15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1093160590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 UTOPIA PKWY",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113574142",
            "telephone_number": "718-819-6805",
            "fax_number": "347-841-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHAPMAN PKWY",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117901756",
            "telephone_number": "718-819-6805",
            "fax_number": "347-841-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "718-819-6805"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.