Individual provider Active NPI

Piotr Sroka, P.T.

  • Physical Therapist
  • Copiague, NY
National Provider Identifier
1124023478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013642 Issued in NY
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

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 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

IdentifierTypeStateIssuer
02020175MedicaidNY
Q31391OtherNYBLUECROSS BLUESHIELD-MP
6604263OtherNYGHI
AZ00952OtherNYMDNY
Q31392OtherNYBLUE CROSS BLUE SHIELD
819836OtherNYMPN
013642OtherNYHIP
195036OtherNYUNITED HEALTHCARE
A2517394OtherNYOXFORD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

Verify at the official NPI Registry.