Individual provider Active NPI

Jason Joseph Weeks, PT

  • Physical Therapist
  • West Babylon, NY
National Provider Identifier
1114018736
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
020636 Issued in NY
Practice address
580 W Montauk Hwy
West Babylon, NY 11704-8307
Phone
(631) 422-0900
Fax
(631) 422-0900
NPI assigned
Sep 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 020636 NY Primary

Addresses

Primary practice location

580 W Montauk Hwy
West Babylon, NY 11704-8307

Mailing address

20 Faith Dr
Hampton Bays, NY 11946-2629
Phone (631) 422-0900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061218000519 NY Practitioner - Physical Therapist in Private Practice 7113962515 Practice locations: East Quogue, NY

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9 Beechnut CT
East Quogue, NY 11942-4710
Phone (631) 728-7029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020636NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back on Track Physical Therapy PLLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114018736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 FAITH DR",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119462629",
            "telephone_number": "631-422-0900",
            "fax_number": "631-422-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W MONTAUK HWY",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117048307",
            "telephone_number": "631-422-0900",
            "fax_number": "631-422-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEKS",
        "first_name": "JASON",
        "middle_name": "JOSEPH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.