Individual provider Active NPI

Sinead Fitzgibbon, PT, PHD

  • Orthopedic Physical Therapist
  • Sag Harbor, NY
National Provider Identifier
1275503567
Registry record updated Mar 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
171741 Issued in UT
Practice address
34 Bay St
Sag Harbor, NY 11963-3104
Phone
(631) 725-4450
Fax
(631) 725-6206
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 171741 UT Primary

Addresses

Primary practice location

34 Bay St
Sag Harbor, NY 11963-3104

Mailing address

PO Box 2333
Sag Harbor, NY 11963
Phone (631) 484-5416

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070621000706 NY Practitioner - Physical Therapist in Private Practice 5294834867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Latitude Physical TherapyGroup PAC ID 7810340296, 6 clinicians

Practice addresses (Care Compare)

34 Bay St
Suite 205206
Sag Harbor, NY 11963-3104
Phone (631) 919-5189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
171741UTMDOrthopedic Physical Therapist
017174NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Latitude Physical Therapy Orthopedic CurrentSince Feb 1, 2024 Accepting new patients
Manual & Sports Physical Therapy, PC PastSince May 1, 2015 Accepting new patients

Locations

50 E 42nd St
Rm 702
New York, NY 10017
Phone (212) 470-2735

34 Bay St
Ste 205
Sag Harbor, NY 11963
Phone (631) 919-5189

34 Bay St
Sag Harbor, NY 11963
Phone (212) 517-6555

34 Bay St
#205206
Sag Harbor, NY 11963
Phone (631) 919-5189

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583625600000",
    "number": "1275503567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2333",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "11963",
            "telephone_number": "631-484-5416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 BAY ST",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119633104",
            "telephone_number": "631-725-4450",
            "fax_number": "631-725-6206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGIBBON",
        "first_name": "SINEAD",
        "credential": "PT, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2020-03-08",
        "certification_date": "2020-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "UT",
            "license": "171741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sag Harbor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2020; 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.