Jacek Golis, MS PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

025552 Issued in NY

Practice address

501 Washington Avenue
Pleasantville Physical Therapy & Sports Care PC
Pleasantville, NY 10570

Phone

(914) 741-2767

Fax

(914) 741-2776

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Physical Therapy, Occupational Therapy and Speech Language PAGroup PAC ID 7012997638, 385 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path

  • Physical Therapist
  • Harrison, NY
  • NPI 1396799409
  Medicare reassignment Care Compare group
• Rye Brook Physical Medicine and Rehabilitation, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Thornwood, NY
  • NPI 1891141750
  Medicare reassignment NPD
• New Rochelle Physical Therapy

  • Specialist
  • New Rochelle, NY
  • NPI 1093755852
  NPD (past)
• Pleasantville Physical Therapy Sports Care PC,

  • Physical Therapist
  • Mount Kisco, NY
  • NPI 1952307571
  NPD (past)
• Westchester Oncology & Hematology Group, P.C.

  • Family Nurse Practitioner
  • Hawthorne, NY
  • NPI 1598727315
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265412381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON AVENUE",
            "address_2": "PLEASANTVILLE PHYSICAL THERAPY & SPORTS CARE PC",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "10570",
            "telephone_number": "914-741-2767",
            "fax_number": "914-741-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON AVENUE",
            "address_2": "PLEASANTVILLE PHYSICAL THERAPY & SPORTS CARE PC",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "10570",
            "telephone_number": "914-741-2767",
            "fax_number": "914-741-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLIS",
        "first_name": "JACEK",
        "name_prefix": "Mr.",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET CIGNA HMO",
            "identifier": "0222701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET USFH",
            "identifier": "0222701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1177828",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET AETNA HMO",
            "identifier": "0013701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "Q34B8",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET HEALTHNET",
            "identifier": "0222701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7022766",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PPO",
            "identifier": "0764866",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvonne Nanette Gaschke, PHD
• Michael Joseph Geremino, D.D.S.
• Deja Gill, LPN
• Russell Glover
• Paul Glushakov, PT, DPT, CSCS
• Sandra Reis Gomes, PT, DPT
• Vaughn Michael Gooding
• Andrea D Gordon, LCSWR
• Lily Horwitz Gordon, LCSW
• Rina Gorvokaj, LMSW

• Physical Therapist in Pleasantville, NY
• Providers in Pleasantville, 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 Jul 8, 2007; 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.