Individual provider Active NPI

Ryan Dinneny

  • Physical Therapy Clinic/Center
  • Staten Island, NY
National Provider Identifier
1205337300
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
042760 Issued in NY
Practice address
19 Emmet Ave
Staten Island, NY 10306-2719
Phone
(917) 757-9023
NPI assigned
Feb 23, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 042760 NY Primary

Addresses

Primary practice location

19 Emmet Ave
Staten Island, NY 10306-2719

Mailing address

19 Emmet Ave
Staten Island, NY 10306-2719

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181012000329 NY Practitioner - Physical Therapist in Private Practice 3072865435 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042760NYMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Esd PT OT & SLP PLLC Physical Therapy CurrentSince Oct 1, 2019 Accepting new patients
Wal Occupational Therapy PC Physical Therapy CurrentSince Mar 1, 2025 Accepting new patients
Rehab on Wheels OT PT PLLC Physical Therapy CurrentSince Sep 1, 2018 Accepting new patients
Prokinetics Physical Therapy P.C. PastSince Jul 5, 2023 Accepting new patients

Locations

8419 Bay Pkwy
Brooklyn, NY 11214
Phone (718) 259-0199

174 Bay 29th St
Ste C1
Brooklyn, NY 11214
Phone (646) 750-4455

1656 E 12th St
Fl 2
Brooklyn, NY 11229
Phone (718) 998-3020

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

212 Cromwell Ave
Staten Island, NY 10305
Phone (718) 285-4190

Organizations & group practices 4

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": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1205337300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 EMMET AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 EMMET AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062719",
            "telephone_number": "917-757-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINNENY",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "042760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.