Active NPI
Malik Campbell
- Physical Therapist
- Fleetwood, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 051191
- Practice address
- 559 Gramatan Ave Ste 203-205
Fleetwood, NY 10552-2155 - Phone
- (914) 371-1990
- NPI assigned
- Nov 16, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 051191 | NY | Primary |
Addresses
Primary practice location
559 Gramatan Ave Ste 203-205
Fleetwood, NY 10552-2155
Mailing address
576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Petersville Rd
New Rochelle, NY 10801-4465
Phone (914) 636-5595
44 Saint Marks PL
New York, NY 10003-8118
Phone (212) 529-5966
559 Gramatan Ave
Suite 203
Mount Vernon, NY 10552-2156
Phone (914) 371-1990
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.88 of 100
- Quality
- 75.15
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051191 | NY | MD | Oncology Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports Physical Therapy Occupational Therapy and Rehabilitation Servic | Current | Accepting new patients | |
| Sports Physical Therapy Occupational Therapy and Rehabilitation Servic | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Orthopedic and Sports Physical Therapy | Physical Therapist | Past | Accepting new patients |
| Professional Orthopedic and Sports Physical Therapy PC | Physical Therapist | Past | Accepting new patients |
Locations
123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248
576 Broadhollow Rd
Melville, NY 11747
3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816
559 Gramatan Ave
Ste 203
Mount Vernon, NY 10552
Phone (914) 371-1990
9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212
2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610
Organizations & group practices 7
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700092800000",
"number": "1346015708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 BROADHOLLOW RD",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117475002",
"telephone_number": "631-359-5859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "559 GRAMATAN AVE STE 203-205",
"city": "FLEETWOOD",
"state": "NY",
"postal_code": "105522155",
"telephone_number": "914-371-1990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "MALIK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-16",
"last_updated": "2023-11-16",
"certification_date": "2023-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "051191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fleetwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.