Back in Action Physical Therapy

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

020541-1 Issued in NY

Legal business name

BACK IN ACTION PHYSICAL THERAPY

Practice address

55 Hopewell Dr
Stony Brook, NY 11790-2340

Phone

(631) 258-9538

NPI assigned

Sep 23, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Michael V Procaccini, P.T . M.S.NPI 1740222959

Title

Physical Therapist

Phone

(631) 941-3295

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Vincent Procaccini, P.T.

  • Physical Therapist
  • Stony Brook, NY
  • NPI 1740222959
  NPD (past) Authorized official
• Elisa S Procaccini, MSPT

  • Physical Therapist
  • Patchogue, NY
  • NPI 1437222197
  NPD (past)

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1104076413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HOPEWELL DR",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902340",
            "telephone_number": "631-258-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HOPEWELL DR",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902340",
            "telephone_number": "631-258-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN ACTION PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "PROCACCINI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "631-941-3295",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T . M.S."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "020541-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "Q12B71",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Naguib Shaker Azab
• Syed Ali Azim, M.D.
• Sruthi Babu
• Silva Baburyan, MD
• Joseph W. Bacchi III, M.D.
• William W Backus, M.D.
• Valjean Bacot-Davis
• Yasaman Badakhshi
• James Badia, MD
• Barbara Badio, MD

• Home Health Agency in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Home Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.