Individual provider Active NPI

Eric A Johnson, DPT

  • Physical Therapist
  • New City, NY
National Provider Identifier
1316581044
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
16 Squadron Blvd
New City, NY 10956-5259
Phone
(845) 300-0568
NPI assigned
Nov 6, 2019
Last updated
Nov 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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 NU Primary

Addresses

Primary practice location

16 Squadron Blvd
New City, NY 10956-5259

Mailing address

199 Waters Edge
Valley Cottage, NY 10989-1611
Phone (845) 300-0568

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191210002021 NY Practitioner - Physical Therapist in Private Practice 3072946706 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040137NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
New York Physical and Occupational Therapy Services, PLLC Physical Therapist CurrentSince Jan 9, 2020 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Jan 19, 2020 Accepting new patients

Locations

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

800 E Gate Blvd
Garden City, NY 11530

1000 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 466-4700

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1316581044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 WATERS EDGE",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109891611",
            "telephone_number": "845-300-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SQUADRON BLVD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565259",
            "telephone_number": "845-300-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIC",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.