NPIMap

Organization Active NPI

Metro Sports Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Garden City, NY
National Provider Identifier
1184972879
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
METRO SPORTS PHYSICAL THERAPY PC
Practice address
401 Franklin Ave
Suite 109
Garden City, NY 11530-5942
Phone
(516) 742-4222
NPI assigned
Aug 28, 2012
Last updated
Nov 28, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
METRO SPORTS PHYSICAL THERAPY PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name
Michael CormicanNPI 1912064452
Title
Physical Therapist
Phone
(516) 742-4222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

401 Franklin Ave
Suite 109
Garden City, NY 11530-5942

Mailing address

401 Franklin Ave
Suite 109
Garden City, NY 11530-5942

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121024000237 NY Part B Supplier - Clinic/Group Practice 5698925857 Receives reassigned benefits from 3 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Metro Sports Physical Therapy PC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1184972879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 FRANKLIN AVE",
            "address_2": "SUITE 109",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 FRANKLIN AVE",
            "address_2": "SUITE 109",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305942",
            "telephone_number": "516-742-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO SPORTS PHYSICAL THERAPY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METRO SPORTS PHYSICAL THERAPY PC",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "CORMICAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "516-742-4222"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.