Individual provider Active NPI

Reese Sipala

  • Physical Therapist
  • Greenlawn, NY
National Provider Identifier
1114745007
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
053205 Issued in NY
Practice address
92 Broadway Ste 102
Greenlawn, NY 11740-1328
Phone
(631) 938-1541
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 053205 NY Primary

Addresses

Primary practice location

92 Broadway Ste 102
Greenlawn, NY 11740-1328

Mailing address

420 4TH St
East Northport, NY 11731-2931
Phone (631) 576-5510

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
053205NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Oct 7, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Oct 7, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients

Locations

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

92 Broadway
Ste 102
Greenlawn, NY 11740
Phone (631) 262-7855

576 Broadhollow Rd
Melville, NY 11747

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": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1114745007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 4TH ST",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312931",
            "telephone_number": "631-576-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 BROADWAY STE 102",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401328",
            "telephone_number": "631-938-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPALA",
        "first_name": "REESE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "053205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenlawn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.