Individual provider Active NPI

Ryan Olivieri, PT, DPT

  • Physical Therapist
  • Bay Shore, NY
National Provider Identifier
1104609924
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
051025 Issued in NY
Practice address
8 Saxon Ave Ste B
Bay Shore, NY 11706-7036
Phone
(631) 328-2624
NPI assigned
Aug 15, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 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 051025 NY Primary

Addresses

Primary practice location

8 Saxon Ave Ste B
Bay Shore, NY 11706-7036

Mailing address

2342 Locust Ave
Ronkonkoma, NY 11779-6522

Other practice location 1

560 Walt Whitman Rd Ste 1
Melville, NY 11747-2114
Phone (631) 923-2288

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230907001401 NY Practitioner - Physical Therapist in Private Practice 3971967159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Step Physical Therapy of Long IslandGroup PAC ID 3072771948, 8 clinicians

Practice addresses (Care Compare)

560 Walt Whitman Rd
Suite 1
Melville, NY 11747-2114
Phone (631) 923-2288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
First Step Physical Therapy of Long Island Physical Therapist CurrentSince Aug 17, 2023 Accepting new patients

Locations

8 Saxon Ave
Ste B
Bay Shore, NY 11706
Phone (631) 328-2624

560 Walt Whitman Rd
Ste 1
Melville, NY 11747
Phone (631) 923-2288

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1104609924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 LOCUST AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 SAXON AVE STE B",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067036",
            "telephone_number": "631-328-2624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 Walt Whitman Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Melville",
            "state": "NY",
            "postal_code": "117472114",
            "country_code": "US",
            "telephone_number": "631-923-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVIERI",
        "first_name": "RYAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "051025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.