Individual provider Active NPI

Ann Mary John

  • Physical Therapist
  • New Hyde Park, NY
National Provider Identifier
1104527357
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1605 Hillside Ave
New Hyde Park, NY 11040-2603
Phone
(516) 616-0942
Fax
(516) 616-0943
NPI assigned
Mar 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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 Primary

Addresses

Primary practice location

1605 Hillside Ave
New Hyde Park, NY 11040-2603

Mailing address

26007 Union Tpke # 2
Glen Oaks, NY 11004-1345
Phone (347) 433-1708

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260303002528 NY Practitioner - Physical Therapist in Private Practice 0749762466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 E Gate Blvd
Garden City, NY 11530-2105
Phone (516) 745-8070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051906NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Feb 10, 2026 Accepting new patients
Healing Touch Physical Therapy & Rehabilitation P C Physical Therapist CurrentSince Mar 19, 2023 Accepting new patients
In-Motion Physical Therapy, P.C. PastSince Mar 19, 2023 Accepting new patients

Locations

805 Broadway
Ste 100
Amityville, NY 11701
Phone (631) 608-8874

800 E Gate Blvd
Garden City, NY 11530

1605 Hillside Ave
New Hyde Park, NY 11040
Phone (516) 428-8803

Organizations & group practices 3

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": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1104527357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26007 UNION TPKE # 2",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041345",
            "telephone_number": "347-433-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 HILLSIDE AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402603",
            "telephone_number": "516-616-0942",
            "fax_number": "516-616-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "ANN MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.