Active NPI
Laura Ann McMahon-Simonetti, PHYSICAL THERAPIST
- Physical Therapist
- Selden, NY
National Provider Identifier
1144343633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 012625-1
- Practice address
- 1312 Middle Country Rd
Selden, NY 11784-2526 - Phone
- (631) 732-0700
- Fax
- (631) 732-9046
- NPI assigned
- Apr 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 012625-1 | NY | Primary |
Addresses
Primary practice location
1312 Middle Country Rd
Selden, NY 11784-2526
Mailing address
1312 Middle Country Rd
Selden, NY 11784-2526
Phone (631) 732-0700
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012625-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532304000000",
"number": "1144343633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1312 MIDDLE COUNTRY RD",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842526",
"telephone_number": "631-732-0700",
"fax_number": "631-732-9046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1312 MIDDLE COUNTRY RD",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842526",
"telephone_number": "631-732-0700",
"fax_number": "631-732-9046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHON-SIMONETTI",
"first_name": "LAURA",
"middle_name": "ANN",
"name_prefix": "Prof.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2018-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "012625-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Selden, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.