NPIMap

Organization Active NPI

Robert Mosca Physical Therapy, PLLC

  • Specialist
  • Stony Brook, NY
National Provider Identifier
1235545732
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0344851 Issued in NY
Legal business name
ROBERT MOSCA PHYSICAL THERAPY, PLLC
Practice address
2500 Nesconset Hwy
Stony Brook, NY 11790-2555
Phone
(631) 751-7988
Fax
(631) 751-7989
NPI assigned
Jul 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Authorized official

Name
Krystina Berg
Title
Office Manager
Phone
(631) 751-7988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 0344851 NY Primary

Addresses

Primary practice location

2500 Nesconset Hwy
Stony Brook, NY 11790-2555

Mailing address

2500 Nesconset Hwy
Stony Brook, NY 11790-2555
Phone (631) 751-7988

Other identifiers 1

IdentifierTypeStateIssuer
A400103199OtherNYMEDICARE ID

Other names 1

  • North Island Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150212000704 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5890010979 Receives reassigned benefits from 4 practitioners
Practice locations: Stony Brook, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1235545732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-751-7988",
            "fax_number": "631-751-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-751-7988",
            "fax_number": "631-751-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT MOSCA PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-03",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "KRYSTINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "631-751-7988"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "0344851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "A400103199",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Island Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.