Individual provider Active NPI

Rosalyn Fidel, PT

  • Physical Therapist
  • Smithtown, NY
National Provider Identifier
1295957884
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0231741 Issued in NY
Practice address
45 Terry Rd
North Shore Neurological & Rehab Suite a
Smithtown, NY 11787
Phone
(631) 265-4485
Fax
(631) 265-3620
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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 0231741 NY Primary

Addresses

Primary practice location

45 Terry Rd
North Shore Neurological & Rehab Suite a
Smithtown, NY 11787

Mailing address

45 Terry Rd
Suite a
Smithtown, NY 11787
Phone (631) 265-4485

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0231741NYMDPhysical Therapist
023174NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Empress Ambulance Service LLC Past Accepting new patients
Lifespire, Inc. Past Accepting new patients
Lifespire, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1295957884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 TERRY RD",
            "address_2": "SUITE A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-265-4485",
            "fax_number": "631-265-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 TERRY RD",
            "address_2": "NORTH SHORE NEUROLOGICAL & REHAB SUITE A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-265-4485",
            "fax_number": "631-265-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDEL",
        "first_name": "ROSALYN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0231741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.