Individual provider Active NPI

Gregory E Misch, M.P.T

  • Physical Therapist
  • New York, NY
National Provider Identifier
1124277611
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028066 Issued in NY
Practice address
30 Broad St
12TH Floor
New York, NY 10004-2304
Phone
(212) 587-8606
Fax
(212) 587-9024
NPI assigned
Sep 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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 028066 NY Primary

Addresses

Primary practice location

30 Broad St
12TH Floor
New York, NY 10004-2304

Mailing address

333 Earle Ovington Blvd
Suite 225
Uniondale, NY 11553-3610
Phone (516) 321-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110706000424 NY Practitioner - Physical Therapist in Private Practice 6406034826 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028066NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist CurrentSince Jan 9, 2018 Accepting new patients
Wyckoff Professional Medical Services, PC CurrentSince Nov 1, 2021 Accepting new patients
Bik Orthopedics, PC Physical Therapist CurrentSince Aug 1, 2015 Accepting new patients
Balanced Health Medical PastSince Dec 6, 2022 Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

170 William St
Fl 8
New York, NY 10038
Phone (212) 312-5000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1124277611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 EARLE OVINGTON BLVD",
            "address_2": "SUITE 225",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115533610",
            "telephone_number": "516-321-2400",
            "fax_number": "516-321-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BROAD ST",
            "address_2": "12TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042304",
            "telephone_number": "212-587-8606",
            "fax_number": "212-587-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISCH",
        "first_name": "GREGORY",
        "middle_name": "E",
        "credential": "M.P.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.