Active NPI
Michele Leigh Mensch, ATC,CSCS,CKTP
- Athletic Trainer
- Middle Island, NY
National Provider Identifier
1275561615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000478
- Practice address
- 100 Longwood Rd
Middle Island, NY 11953-2056 - Phone
- (631) 345-9260
- Fax
- (631) 345-5265
- NPI assigned
- Jun 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 000478 | NY | Primary |
Addresses
Primary practice location
100 Longwood Rd
Middle Island, NY 11953-2056
Mailing address
PO Box 407
Moriches, NY 11955-0407
Phone (631) 838-8113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000478 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709337600000",
"number": "1275561615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 407",
"city": "MORICHES",
"state": "NY",
"postal_code": "119550407",
"telephone_number": "631-838-8113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 LONGWOOD RD",
"city": "MIDDLE ISLAND",
"state": "NY",
"postal_code": "119532056",
"telephone_number": "631-345-9260",
"fax_number": "631-345-5265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENSCH",
"first_name": "MICHELE",
"middle_name": "LEIGH",
"name_prefix": "Ms.",
"credential": "ATC,CSCS,CKTP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2024-03-02",
"certification_date": "2024-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "000478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middle Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.