Cosmo Philip Baccarella, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0240191 Issued in NY

Practice address

393 Moffitt Blvd
Islip, NY 11751

Phone

(631) 581-0006

Fax

(631) 581-0990

NPI assigned

Feb 2, 2007

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

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• South Bay Physical Therapy and Sports Rehabilitation PC

  • Physical Therapist
  • Islip, NY
  • NPI 1649318460

  NY, Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174661995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 MOFFITT BLVD",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "11751",
            "telephone_number": "631-581-0006",
            "fax_number": "631-581-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 MOFFITT BLVD",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "11751",
            "telephone_number": "631-581-0006",
            "fax_number": "631-581-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCARELLA",
        "first_name": "COSMO",
        "middle_name": "PHILIP",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0240191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antigone Argyriou, M.D.
• Judith Irene Aries, MS
• Sabine Atherley
• Ligia Augier
• Jeniah Ayler
• Katie Bacigalupo
• Jean Claude Badio, REGISTERED NURSE
• Nana Yaa Anima Baffour-Awuah, M.D.
• Josie J. Bajarias, PT
• Barbara A Ball, SLP

• All providers in Islip, NY
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.