Active NPI
Healthy at Home Physical Therapy, PC
- Physical Therapist
- Ridge, NY
National Provider Identifier
1346834801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- HEALTHY AT HOME PHYSICAL THERAPY, PC
- Practice address
- 166 Lakeside TRL
Ridge, NY 11961-2246 - Phone
- (631) 300-0769
- NPI assigned
- Feb 25, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jim Megna
- Title
- Owner
- Phone
- (631) 300-0769
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
166 Lakeside TRL
Ridge, NY 11961-2246
Mailing address
166 Lakeside TRL
Ridge, NY 11961-2246
Phone (631) 300-0769
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210310000540 | NY | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 5092121491 |
Receives reassigned benefits from 1 practitioner Practice locations: Ridge, NY |
National Provider Directory
National Provider Directory- Tax ID family
- Healthy at Home Physical Therapy PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Physical Therapist
- Ridge, NY
- NPI 1962269969
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614211200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1709769600000",
"number": "1346834801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 LAKESIDE TRL",
"city": "RIDGE",
"state": "NY",
"postal_code": "119612246",
"telephone_number": "631-300-0769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 LAKESIDE TRL",
"city": "RIDGE",
"state": "NY",
"postal_code": "119612246",
"telephone_number": "631-300-0769"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTHY AT HOME PHYSICAL THERAPY, PC",
"organizational_subpart": "NO",
"enumeration_date": "2021-02-25",
"last_updated": "2024-03-07",
"certification_date": "2024-03-07",
"status": "A",
"authorized_official_last_name": "MEGNA",
"authorized_official_first_name": "JIM",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "631-300-0769"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ridge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.