Justin Andrew Minerva, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

031214-1 Issued in NY

Practice address

11 Canby CT
West Islip, NY 11795-2309

Phone

(631) 482-8870

NPI assigned

Jan 27, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• L.I. Pro Physical Therapy P.C.

  • Physical Therapist
  • West Islip, NY
  • NPI 1104164656
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469232000000",
    "number": "1124324942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CANBY CT",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952309",
            "telephone_number": "631-482-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CANBY CT",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952309",
            "telephone_number": "631-482-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINERVA",
        "first_name": "JUSTIN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-27",
        "last_updated": "2016-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031214-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Michaelides, DO
• Mike E. Calderon DDS PC
• Jennifer Miller, PA
• Susan Milligan, PA
• Kaleighan Mills, LMSW
• Amanda Elise Mirchel, PHYSICIAN ASSISTANT
• Joseph E Mirro
• Symeon Missios, M.D.
• Mitchell I. Weinstein, D.O., P.C.
• Dorothy Mock, PA

• Physical Therapist in West Islip, NY
• Providers in West Islip, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2016; 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.