Individual provider Active NPI

Stephan E Ungar, PT

  • Physical Therapist
  • Patchogue, NY
National Provider Identifier
1306955547
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
011026-1 Issued in NY
Practice address
440 Waverly Ave Ste 5
Patchogue, NY 11772-1597
Phone
(631) 758-5700
Fax
(631) 758-7005
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 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 011026-1 NY Primary

Addresses

Primary practice location

440 Waverly Ave Ste 5
Patchogue, NY 11772-1597

Mailing address

440 Waverly Ave Ste 5
Patchogue, NY 11772-1597
Phone (631) 758-5700

Other identifiers 13

IdentifierTypeStateIssuer
139551POtherNYHIP
14378140OtherFIRST HEALTH
2788OtherNYHERITAGE
P1939994OtherOXFORD
43641478OtherNYAETNA
65002050OtherNYRAIL ROAD MEDICARE
102481OtherNYVYTRA
SF0003105OtherNYSELECT PRO
2287876OtherNYAETNA
11350404040OtherNYNO FAULT
1259717OtherNYUNITED HEALTH CARE
Q86011OtherNYEMPIRE BLUE CROSS / SHIEL
AZ00653OtherNYMDNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081009000021 NY Practitioner - Physical Therapist in Private Practice 2567539430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State Un of Ny, Stony Brook School of Dental Med, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

440 Waverly Ave
Suite 5
Patchogue, NY 11772-1597
Phone (631) 758-5700

800 E Gate Blvd
Garden City, NY 11530-2105
Phone (516) 745-8070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011026-1NYMDAdult Development & Aging Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Motion Dynamics Physical Therapy PC Physical Therapist CurrentSince Jul 15, 2000 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Sep 9, 2025 Accepting new patients

Locations

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

440 Waverly Ave
Ste 5
Patchogue, NY 11772
Phone (631) 758-5700

322 W Main St
Patchogue, NY 11772
Phone 5167458070520

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

Networks

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

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1306955547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 WAVERLY AVE STE 5",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721597",
            "telephone_number": "631-758-5700",
            "fax_number": "631-758-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WAVERLY AVE STE 5",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721597",
            "telephone_number": "631-758-5700",
            "fax_number": "631-758-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNGAR",
        "first_name": "STEPHAN",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "011026-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "139551P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "14378140",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HERITAGE",
            "identifier": "2788",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1939994",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "43641478",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "65002050",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "102481",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT PRO",
            "identifier": "SF0003105",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2287876",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO FAULT",
            "identifier": "11350404040",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1259717",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS / SHIEL",
            "identifier": "Q86011",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AZ00653",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.