NPIMap

Organization Active NPI

Universus Physical Therapy PLLC

  • Physical Therapist
  • Huntington, NY
National Provider Identifier
1124394457
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028157 Issued in NY
Legal business name
UNIVERSUS PHYSICAL THERAPY PLLC
Practice address
221 E Main St
Huntington, NY 11743-2924
Phone
(631) 533-2888
Fax
(631) 683-5584
NPI assigned
Mar 30, 2012
Last updated
May 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Authorized official

Name
Shaden Ghattas Ryglewicz, P.T.
Title
Owner
Phone
(631) 271-9151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 028157 NY Primary

Addresses

Primary practice location

221 E Main St
Huntington, NY 11743-2924

Mailing address

221 E Main St
Huntington, NY 11743-2924
Phone (631) 533-2888

Other identifiers 1

IdentifierTypeStateIssuer
028157OtherNYLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120626000445 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5193980159 Receives reassigned benefits from 15 practitioners
Practice locations: Huntington, NY

National Provider Directory

National Provider Directory

Locations

223 E Main St
Huntington, NY 11743

221 E Main St
Huntington, NY 11743
Phone (631) 533-2888

232 E Main St
Ste 3
Huntington, NY 11743
Phone (631) 533-2888

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1124394457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432924",
            "telephone_number": "631-533-2888",
            "fax_number": "631-638-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432924",
            "telephone_number": "631-533-2888",
            "fax_number": "631-683-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSUS PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "GHATTAS RYGLEWICZ",
        "authorized_official_first_name": "SHADEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-271-9151",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "028157",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.