Active NPI
Peter McNelis
- Physical Therapist
- Rockaway Park, NY
National Provider Identifier
1194180190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 039100-1
- Practice address
- 221 Beach 117TH St
Rockaway Park, NY 11694-2056 - Phone
- (347) 287-5812
- NPI assigned
- Dec 18, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 039100-1 | NY | Primary |
Addresses
Primary practice location
221 Beach 117TH St
Rockaway Park, NY 11694-2056
Mailing address
221 Beach 117TH St
Rockaway Park, NY 11694-2056
Phone (347) 287-5812
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039100-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450396800000",
"number": "1194180190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 BEACH 117TH ST",
"city": "ROCKAWAY PARK",
"state": "NY",
"postal_code": "116942056",
"telephone_number": "347-287-5812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 BEACH 117TH ST",
"city": "ROCKAWAY PARK",
"state": "NY",
"postal_code": "116942056",
"telephone_number": "347-287-5812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNELIS",
"first_name": "PETER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-18",
"last_updated": "2015-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "039100-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockaway Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.