Individual provider Active NPI

Samkutty Cyriac, PT

  • Physical Therapist
  • Garden City, NY
National Provider Identifier
1104877422
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027084 Issued in NY
Practice address
1100 Stewart Ave Ste B
Garden City, NY 11530-4839
Phone
(516) 427-5380
Fax
(516) 386-6666
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 027084 NY
Physical Therapist 225100000X 027084 NY Primary

Addresses

Primary practice location

1100 Stewart Ave Ste B
Garden City, NY 11530-4839

Mailing address

1043 N 5TH St
New Hyde Park, NY 11040-2939
Phone (917) 560-1734

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060106000884 NY Practitioner - Physical Therapist in Private Practice 5092738807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rapha Office and Home Physical Therapy Services PCGroup PAC ID 1759304561, 3 clinicians

Practice addresses (Care Compare)

1100 Stewart Ave
Suite B
Garden City, NY 11530-4839
Phone (516) 888-0123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027084NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rapha Office & Home Physical Therapy Services P.C. CurrentSince Jul 9, 2014 Accepting new patients
Bienetre Medical PC Physical Therapist Past Accepting new patients

Locations

1100 Stewart Ave
Ste B
Garden City, NY 11530
Phone (516) 427-5380

Organizations & group practices 2

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1104877422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 N 5TH ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402939",
            "telephone_number": "917-560-1734",
            "fax_number": "516-352-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 STEWART AVE STE B",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304839",
            "telephone_number": "516-427-5380",
            "fax_number": "516-386-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYRIAC",
        "first_name": "SAMKUTTY",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "027084",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027084",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 18, 2025; 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.