Active NPI
Piotr Sroka, P.T.
- Physical Therapist
- Copiague, NY
National Provider Identifier
1124023478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 013642
- Practice address
- 517 Oak St
Copiague, NY 11726-3244 - Phone
- (631) 789-3789
- Fax
- (631) 789-3728
- NPI assigned
- Jun 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 013642 | NY | Primary |
Addresses
Primary practice location
517 Oak St
Copiague, NY 11726-3244
Mailing address
36 Imperial Dr
Miller Place, NY 11764-3222
Phone (631) 476-7686
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02020175 | Medicaid | NY | |
| Q31391 | Other | NY | BLUECROSS BLUESHIELD-MP |
| 6604263 | Other | NY | GHI |
| AZ00952 | Other | NY | MDNY |
| Q31392 | Other | NY | BLUE CROSS BLUE SHIELD |
| 819836 | Other | NY | MPN |
| 013642 | Other | NY | HIP |
| 195036 | Other | NY | UNITED HEALTHCARE |
| A2517394 | Other | NY | OXFORD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110510000742 | NY | Practitioner - Physical Therapist in Private Practice | 3678759586 | Practice locations: Copiague, NY; Miller Place, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
595 Route 25a
Suite 7
Miller Place, NY 11764-2648
Phone (631) 476-7686
632 Oak St
Copiague, NY 11726-3217
Phone (631) 789-3789
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124023478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 IMPERIAL DR",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117643222",
"telephone_number": "631-476-7686",
"fax_number": "631-821-3462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 OAK ST",
"city": "COPIAGUE",
"state": "NY",
"postal_code": "117263244",
"telephone_number": "631-789-3789",
"fax_number": "631-789-3728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SROKA",
"first_name": "PIOTR",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "013642",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02020175",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD-MP",
"identifier": "Q31391",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "6604263",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDNY",
"identifier": "AZ00952",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Q31392",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MPN",
"identifier": "819836",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP",
"identifier": "013642",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "195036",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "A2517394",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Copiague, 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.