Individual provider Active NPI

Matthew Masciandaro, DPT FMT

  • Physical Therapist
  • East Northport, NY
National Provider Identifier
1215309562
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
038144-1 Issued in NY
Practice address
279 Larkfield Rd
East Northport, NY 11731-2415
Phone
(631) 261-1370
NPI assigned
Oct 27, 2015
Last updated
Oct 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 038144-1 NY Primary

Addresses

Primary practice location

279 Larkfield Rd
East Northport, NY 11731-2415

Mailing address

279 Larkfield Rd
East Northport, NY 11731-2415
Phone (631) 261-1370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191018000787 NY Practitioner - Physical Therapist in Private Practice 1254662463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Pro Sports Physical Therapy PCGroup PAC ID 9739071481, 10 clinicians

Practice addresses (Care Compare)

467 New York Ave
Huntington, NY 11743-3557
Phone (631) 424-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038144-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Aug 9, 2024 Accepting new patients
Prosports Physical Therapy PC CurrentSince Nov 29, 2023 Accepting new patients
Suffolk County Physical Therapy P C Physical Therapist CurrentSince Oct 7, 2019 Accepting new patients

Locations

279 Larkfield Rd
East Northport, NY 11731
Phone (631) 261-1370

467 New York Ave
Unit 1
Huntington, NY 11743

11 Birch Hill Rd
Locust Valley, NY 11560
Phone (516) 801-6020

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1215309562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312415",
            "telephone_number": "631-261-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312415",
            "telephone_number": "631-261-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCIANDARO",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "DPT FMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-27",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "038144-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.