Organization Active NPI

Island Shore Physical Therapy, LLP

  • Physical Therapy Clinic/Center
  • East Islip, NY
National Provider Identifier
1295911071
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
4142-1 Issued in NY
Legal business name
ISLAND SHORE PHYSICAL THERAPY, LLP
Practice address
174 E Main St
East Islip, NY 11730-2633
Phone
(631) 277-9321
Fax
(631) 277-9394
NPI assigned
Jan 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Authorized official

Name
Mrs. Megan McKiernan
Title
Office Manager
Phone
(631) 277-9283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 4142-1 NY Primary

Addresses

Primary practice location

174 E Main St
East Islip, NY 11730-2633

Mailing address

174 E Main St
East Islip, NY 11730-2633
Phone (631) 277-9283

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120124000557 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7911174479 Receives reassigned benefits from 3 practitioners
Practice locations: Bay Shore, NY; East Islip, NY

National Provider Directory

National Provider Directory
Tax ID family
Nicole Gick4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

250 Higbie Ln
West Islip, NY 11795
Phone (631) 422-0404

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768953600000",
    "number": "1295911071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 E MAIN ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302633",
            "telephone_number": "631-277-9283",
            "fax_number": "631-277-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 E MAIN ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302633",
            "telephone_number": "631-277-9321",
            "fax_number": "631-277-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND SHORE PHYSICAL THERAPY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A",
        "authorized_official_last_name": "MCKIERNAN",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "631-277-9283",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "4142-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.