Individual provider Active NPI

Christopher Horan

  • Geriatric Physical Therapist
  • Oceanside, NY
National Provider Identifier
1124408646
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
034028 Issued in NY
Practice address
3941 Bea CT
Oceanside, NY 11572-5907
Phone
(516) 459-9439
Fax
(516) 706-2182
NPI assigned
Jun 1, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 034028 NY Primary

Addresses

Primary practice location

3941 Bea CT
Oceanside, NY 11572-5907

Mailing address

3041 Bea CT
Oceanside, NY 11572
Phone (516) 459-9439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034028NYMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Advantage Physical Therapy PC PastSince Oct 1, 2009 Accepting new patients

Organizations & group practices 1

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": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1124408646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3041 BEA CT",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "11572",
            "telephone_number": "516-459-9439",
            "fax_number": "516-706-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3941 BEA CT",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115725907",
            "telephone_number": "516-459-9439",
            "fax_number": "516-706-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORAN",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "034028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.