Organization Active NPI

Jermaine Lee Physical Therapy PLLC

  • Orthopedic Physical Therapist
  • Rockville Centre, NY
National Provider Identifier
1114742814
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
JERMAINE LEE PHYSICAL THERAPY PLLC
Practice address
411 Clinton Ave
Rockville Centre, NY 11570-3302
Phone
(516) 425-3985
NPI assigned
Nov 18, 2024
Last updated
May 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Jermaine LeeNPI 1295235109
Title
Owner
Phone
(516) 425-3985

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

411 Clinton Ave
Rockville Centre, NY 11570-3302

Mailing address

411 Clinton Ave
Rockville Centre, NY 11570-3302
Phone (516) 425-3985

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241218001428 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4385171115 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville Centre, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1114742814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 CLINTON AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703302",
            "telephone_number": "516-425-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CLINTON AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703302",
            "telephone_number": "516-425-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERMAINE LEE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JERMAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-425-3985"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.