Individual provider Active NPI

Robert Panariello, PT

  • Physical Therapist
  • Garden City, NY
National Provider Identifier
1104872985
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7940 Issued in NY
Practice address
645 Stewart Ave
Suite 1
Garden City, NY 11530-4709
Phone
(516) 794-3278
Fax
(516) 794-7578
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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 7940 NY Primary

Addresses

Primary practice location

645 Stewart Ave
Suite 1
Garden City, NY 11530-4709

Mailing address

645 Stewart Ave
Suite 1
Garden City, NY 11530-4709
Phone (516) 794-3278

Other identifiers 1

IdentifierTypeStateIssuer
Q05U5Q4FH1OtherNYMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7940NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Dec 28, 2016 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients

Locations

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

645 Stewart Ave
Garden City, NY 11530
Phone (516) 794-3278

645 Stewart Ave
Unit 1
Garden City, NY 11530
Phone (516) 794-3278

90 Northern Blvd
Greenvale, NY 11548
Phone (516) 626-5080

576 Broadhollow Rd
Melville, NY 11747

16 E 52nd St
Fl 6
New York, NY 10022
Phone (212) 752-2400

14 Wall St
New York, NY 10005
Phone (212) 227-0272

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1104872985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 STEWART AVE",
            "address_2": "SUITE 1",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304709",
            "telephone_number": "516-794-3278",
            "fax_number": "516-794-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 STEWART AVE",
            "address_2": "SUITE 1",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304709",
            "telephone_number": "516-794-3278",
            "fax_number": "516-794-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANARIELLO",
        "first_name": "ROBERT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "7940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Q05U5Q4FH1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.