Individual provider Active NPI

Jaroslaw Adam Solomianko, DPT

  • Physical Therapist
  • Plainview, NY
National Provider Identifier
1174618904
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
012809 Issued in NY
Practice address
4 Pasadena Dr
Plainview, NY 11803-3706
Phone
(516) 931-2780
Fax
(516) 938-1129
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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 012809 NY Primary

Addresses

Primary practice location

4 Pasadena Dr
Plainview, NY 11803-3706

Mailing address

4 Pasadena Dr
Plainview, NY 11803-3706
Phone (516) 931-2780

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130508000015 NY Practitioner - Physical Therapist in Private Practice 8022255322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Pasadena Dr
Plainview, NY 11803-3706
Phone (516) 931-2780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012809-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
J.G.Wellness Physical Therapy,PC Physical Therapist CurrentSince Apr 29, 2013 Accepting new patients

Organizations & group practices 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1174618904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PASADENA DR",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033706",
            "telephone_number": "516-931-2780",
            "fax_number": "516-938-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PASADENA DR",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033706",
            "telephone_number": "516-931-2780",
            "fax_number": "516-938-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMIANKO",
        "first_name": "JAROSLAW",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.