Individual provider Active NPI

Linda Rose Mildner

  • Physical Therapy Assistant
  • Port Jefferson Station, NY
National Provider Identifier
1144100942
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
014966-01 Issued in NY
Practice address
1500 Route 112 BLDG 9
Port Jefferson Station, NY 11776-3184
Phone
(631) 849-6688
NPI assigned
Sep 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 014966-01 NY Primary

Addresses

Primary practice location

1500 Route 112 BLDG 9
Port Jefferson Station, NY 11776-3184

Mailing address

12 Seneca CT
Port Jefferson Station, NY 11776-4485

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
014966-01NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC CurrentSince Sep 8, 2025 Accepting new patients
Sherrie Glasser, Physical Therapist. PC PastSince Sep 8, 2025 Accepting new patients

Locations

1500 Route 112
Bldg 9
Port Jefferson Station, NY 11776
Phone (631) 849-6688

Organizations & group practices 2

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": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1144100942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SENECA CT",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117764485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112 BLDG 9",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763184",
            "telephone_number": "631-849-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILDNER",
        "first_name": "LINDA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "014966-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.