Organization Active NPI

West Islip Chiropractic, Physical Therapy, Acupuncture, and Adult Health NP, PLLC

  • Chiropractor
  • West Islip, NY
National Provider Identifier
1134928849
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WEST ISLIP CHIROPRACTIC, PHYSICAL THERAPY, ACUPUNCTURE, AND ADULT HEALTH NP, PLLC
Practice address
786 Montauk Hwy Uppr Level
West Islip, NY 11795-4926
Phone
(631) 661-1400
Fax
(631) 661-5242
NPI assigned
Mar 13, 2025
Last updated
Mar 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Authorized official

Name
Dr. Gerard J Smith, DCNPI 1609845114
Title
Owner
Phone
(631) 661-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

786 Montauk Hwy Uppr Level
West Islip, NY 11795-4926

Mailing address

786 Montauk Hwy Uppr Level
West Islip, NY 11795-4926
Phone (631) 661-1400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250728001617 NY Part B Supplier - Clinic/Group Practice 0244747087 Receives reassigned benefits from 2 practitioners
Practice locations: West Islip, NY

National Provider Directory

National Provider Directory

Locations

786 Montauk Hwy
Uppr
West Islip, NY 11795
Phone (631) 661-1400

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1134928849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "786 MONTAUK HWY UPPR LEVEL",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954926",
            "telephone_number": "631-661-1400",
            "fax_number": "631-661-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "786 MONTAUK HWY UPPR LEVEL",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954926",
            "telephone_number": "631-661-1400",
            "fax_number": "631-661-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST ISLIP CHIROPRACTIC, PHYSICAL THERAPY, ACUPUNCTURE, AND ADULT HEALTH NP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-661-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.