Alexander John Ketterer

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

049776 Issued in NY

Practice address

2380 Julia Goldbach Ave
Ronkonkoma, NY 11779-6317

Phone

(631) 438-7444

NPI assigned

Dec 16, 2025

Last updated

Dec 16, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro Physical Occupational Speech Massage Therapy and Acupuncture PLLGroup PAC ID 1254553639, 448 clinicians

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC

  • Occupational Therapist
  • Garden City, NY
  • NPI 1356742365

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1765843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1205791837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 JULIA GOLDBACH AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796317",
            "telephone_number": "631-438-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 JULIA GOLDBACH AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796317",
            "telephone_number": "631-438-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTERER",
        "first_name": "ALEXANDER",
        "middle_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Kelly
• Jennifer Eileen Kelly
• Michele Ann Kelly, CPNP NPP
• Kelle M Kenzik, LCSW
• George Kerrigan
• Ayesha Khatri
• June Kiefer, MSN CS NPP
• Sophia P Kim
• Lauren Rose Kinkaid
• Lynn Marie Klingenberger, RN

• Physical Therapist in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.