Individual provider Active NPI

Maria Fatima Ferreira

  • Pediatric Physical Therapist
  • Port Jefferson Station, NY
National Provider Identifier
1235409442
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
015433 Issued in NY
Practice address
120 Norwood Ave
Port Jefferson Station, NY 11776-2547
Phone
(631) 512-2237
NPI assigned
Jan 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 015433 NY Primary

Addresses

Primary practice location

120 Norwood Ave
Port Jefferson Station, NY 11776-2547

Mailing address

120 Norwood Ave
Port Jefferson Station, NY 11776-2547
Phone (631) 512-2237

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170912002700 NY Practitioner - Physical Therapist in Private Practice 7113290206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimum Therapeutics PT and OT PLLC 41 clinicians

Practice addresses (Care Compare)

1 Huntington Quadrangle
Suite 1S07
Melville, NY 11747-4426
Phone (516) 222-2010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015433NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Therapeutics PT & OT PLLC Pediatrics CurrentSince Aug 6, 2017 Accepting new patients
Propel Physical Therapy PC Pediatrics Past Accepting new patients

Locations

1 Huntington Quadrangle
Ste 1S07
Melville, NY 11747
Phone (516) 222-2010

Organizations & group practices 2

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": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1235409442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NORWOOD AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762547",
            "telephone_number": "631-512-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NORWOOD AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762547",
            "telephone_number": "631-512-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERREIRA",
        "first_name": "MARIA",
        "middle_name": "FATIMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "015433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.