Individual provider Active NPI

Richard Henry Northorn III, DPT

  • Physical Therapist
  • West Islip, NY
National Provider Identifier
1285776815
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0248541 Issued in NY
Practice address
67 Highland Ave
West Islip, NY 11795-3221
Phone
(631) 669-0155
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0248541 NY Primary

Addresses

Primary practice location

67 Highland Ave
West Islip, NY 11795-3221

Mailing address

67 Highland Ave
West Islip, NY 11795-3221
Phone (631) 669-0155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080918000218 NY Practitioner - Physical Therapist in Private Practice 1254407406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reddy Care Physical Therapy PCGroup PAC ID 5890685986, 139 clinicians

Practice addresses (Care Compare)

475 Northern Blvd
Great Neck, NY 11021-4802
Phone (516) 829-0030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0248541NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Aug 1, 2017 Accepting new patients
Reddy Care Physical Therapy PC Physical Therapist CurrentSince Jun 29, 2023 Accepting new patients

Locations

1470 Sunrise Hwy
Bay Shore, NY 11706
Phone (631) 446-1480

475 Northern Blvd
Ste 27
Great Neck, NY 11021

475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

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

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285776815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 HIGHLAND AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953221",
            "telephone_number": "631-669-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 HIGHLAND AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953221",
            "telephone_number": "631-669-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHORN",
        "first_name": "RICHARD",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0248541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

  • 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.