Organization Active NPI

Paragon Physical Therapy, PC

  • Orthopedic Physical Therapist
  • Deer Park, NY
National Provider Identifier
1306163928
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
PARAGON PHYSICAL THERAPY, PC
Practice address
2100 Deer Park Ave
Ste 5
Deer Park, NY 11729-2119
Phone
(631) 242-9200
Fax
(631) 242-9202
NPI assigned
Apr 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Authorized official

Name
Ms. Cheryl A. Christie, PTNPI 1720048283
Title
President/Owner
Phone
(631) 242-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Geriatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251G0304X
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

2100 Deer Park Ave
Ste 5
Deer Park, NY 11729-2119

Mailing address

2100 Deer Park Ave
Ste 5
Deer Park, NY 11729-2119
Phone (631) 242-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160211000269 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1052592508 Receives reassigned benefits from 1 practitioner
Practice locations: Edgewood, NY

National Provider Directory

National Provider Directory

Locations

50 N Industry Ct
Deer Park, NY 11729
Phone (631) 242-9200

2100 Deer Park Ave
Ste 5
Deer Park, NY 11729
Phone (631) 242-9200

250 Executive Dr
Ste X
Edgewood, NY 11717
Phone (531) 242-9200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1306163928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DEER PARK AVE",
            "address_2": "STE 5",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292119",
            "telephone_number": "631-242-9200",
            "fax_number": "631-242-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DEER PARK AVE",
            "address_2": "STE 5",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292119",
            "telephone_number": "631-242-9200",
            "fax_number": "631-242-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAGON PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-21",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "CHRISTIE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "631-242-9200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.