Individual provider Active NPI

William P Coughlin, DPT

  • Physical Therapist
  • Hauppauge, NY
National Provider Identifier
1265674063
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0295431 Issued in NY
Practice address
30 Glenwood Dr
Hauppauge, NY 11788-1007
Phone
(516) 314-2450
NPI assigned
Mar 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0295431 NY Primary
Cardiopulmonary Physical Therapist 2251C2600X 0295431 NY
Ergonomics Physical Therapist 2251E1200X 0295431 NY
Clinical Electrophysiology Physical Therapist 2251E1300X 0295431 NY
Geriatric Physical Therapist 2251G0304X 0295431 NY
Hand Physical Therapist 2251H1200X 0295431 NY
Human Factors Physical Therapist 2251H1300X 0295431 NY
Neurology Physical Therapist 2251N0400X 0295431 NY
Pediatric Physical Therapist 2251P0200X 0295431 NY
Sports Physical Therapist 2251S0007X 0295431 NY
Orthopedic Physical Therapist 2251X0800X 0295431 NY

Addresses

Primary practice location

30 Glenwood Dr
Hauppauge, NY 11788-1007

Mailing address

30 Glenwood Dr
Hauppauge, NY 11788-1007
Phone (516) 314-2450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120223000299 NY Practitioner - Physical Therapist in Private Practice 1951569821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Step Physical Therapy of Long IslandGroup PAC ID 3072771948, 8 clinicians

Practice addresses (Care Compare)

560 Walt Whitman Rd
Suite 1
Melville, NY 11747-2114
Phone (631) 923-2288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0295431NYMDSports Physical Therapist

Networks

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

Organizations & group practices 1

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": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1265674063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 GLENWOOD DR",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117881007",
            "telephone_number": "516-314-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 GLENWOOD DR",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117881007",
            "telephone_number": "516-314-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHLIN",
        "first_name": "WILLIAM",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0295431",
            "primary": true
        },
        {
            "code": "2251C2600X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": "NY",
            "license": "0295431",
            "primary": false
        },
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": "NY",
            "license": "0295431",
            "primary": false
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "NY",
            "license": "0295431",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "0295431",
            "primary": false
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "NY",
            "license": "0295431",
            "primary": false
        },
        {
            "code": "2251H1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Human Factors",
            "state": "NY",
            "license": "0295431",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NY",
            "license": "0295431",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "0295431",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NY",
            "license": "0295431",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "0295431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.