Roger W Wetsell, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

002266 Issued in NY

Practice address

300 Hallock Ave
Port Jefferson Station, NY 11776-1227

Phone

(631) 331-1070

Fax

(631) 331-1126

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Port Jefferson Physical Therapy PC

  • Orthopedic Physical Therapist
  • Port Jefferson Station, NY
  • NPI 1497887756
  NPD (past) Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316045032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DATE CT",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117661804",
            "telephone_number": "631-928-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761227",
            "telephone_number": "631-331-1070",
            "fax_number": "631-331-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETSELL",
        "first_name": "ROGER",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "002266",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NH",
            "license": "2634",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Weaver, LCSW
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• Well Balanced Massage Inc
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• Kailey Veronica White
• Laurie A White, LCSW
• Amanda Marie Wiermann, P.A.
• Richard John Wieting, M.D.

• Orthopedic Physical Therapist in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Orthopedic Physical Therapist in New York

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.