Individual provider Active NPI

Misheel Bernabe

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1144952052
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
048732 Issued in NY
Practice address
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone
(516) 829-0030
Fax
(516) 466-7723
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 048732 NY Primary

Addresses

Primary practice location

475 Northern Blvd Ste 11
Great Neck, NY 11021-4802

Mailing address

475 Northern Blvd Ste 27
Great Neck, NY 11021-4802
Phone (516) 829-0030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220711002660 NY Practitioner - Physical Therapist in Private Practice 6800276684 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048732NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Reddy Care Physical Therapy PC Physical Therapist CurrentSince Jun 29, 2022 Accepting new patients
Reddy Care Physical and Occupational Therapy PLLC Physical Therapist PastSince Jul 5, 2023 Accepting new patients

Locations

20832 Cross Island Pkwy
Ste 32
Bayside, NY 11360
Phone (516) 466-7723

2024 Deer Park Ave
Deer Park, NY 11729
Phone (516) 243-0247

309 Northwest Dr
Farmingdale, NY 11735
Phone (516) 420-2900

27278 Grand Central Pkwy
Floral Park, NY 11005
Phone (516) 344-0030

475 Northern Blvd
Ste 27
Great Neck, NY 11021

475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023

2421 Long Beach Rd
Oceanside, NY 11572
Phone (516) 766-1717

150 Woodbury Rd
Woodbury, NY 11797
Phone (516) 367-1111

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1144952052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 27",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 11",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNABE",
        "first_name": "MISHEEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.