Individual provider Active NPI

Chris Connor, PT

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1093185092
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013847-1 Issued in NY
Practice address
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone
(516) 829-0030
Fax
(516) 466-7723
NPI assigned
Oct 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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 013847-1 NY Primary

Addresses

Primary practice location

475 Northern Blvd Ste 11
Great Neck, NY 11021-4802

Mailing address

475 Northern Blvd Ste 27
Great Neck, NY 11021-4802
Phone (516) 829-0030

Other practice location 1

23 Bayview Ter
Manhasset, NY 11030-1811
Phone (516) 660-1674

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160225001482 NY Practitioner - Physical Therapist in Private Practice 9931404100 Reassigns benefits to 1 organization
Practice locations: Great Neck, NY

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reddy Care Physical Therapy PCGroup PAC ID 5890685986, 139 clinicians

Practice addresses (Care Compare)

475 Northern Blvd
Great Neck, NY 11021-4802
Phone (516) 829-0030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013847NYMDMental Health Counselor
013847-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Reddy Care Physical Therapy PC Physical Therapist CurrentSince Feb 23, 2022 Accepting new patients

Locations

309 Northwest Dr
Farmingdale, NY 11735
Phone (516) 420-2900

475 Northern Blvd
Ste 27
Great Neck, NY 11021

475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023

Organizations & group practices 1

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": "1443744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1093185092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 27",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 11",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Bayview Ter",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110301811",
            "country_code": "US",
            "telephone_number": "516-660-1674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "CHRIS",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-02",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013847-1",
            "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 Feb 23, 2022; 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.