Colin Homola, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

046440 Issued in NY

Practice address

191 Patchogue Yaphank Rd
East Patchogue, NY 11772-4899

Phone

(631) 775-0971

Fax

(631) 475-0975

NPI assigned

Oct 29, 2020

Last updated

Oct 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1174123137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724899",
            "telephone_number": "631-775-0971",
            "fax_number": "631-475-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724899",
            "telephone_number": "631-775-0971",
            "fax_number": "631-475-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMOLA",
        "first_name": "COLIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.professionalcarept.com",
            "affiliation": "N",
            "endpointDescription": "Practice Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "191 Patchogue Yaphank Rd",
            "city": "East Patchogue",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117724899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.