NPIMap

Organization Active NPI

Energize Home Physical Therapy PLLC

  • Physical Therapist
  • Saint James, NY
National Provider Identifier
1356849491
Registry record updated Apr 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0329931 Issued in NY
Legal business name
ENERGIZE HOME PHYSICAL THERAPY PLLC
Practice address
33 Great Oak Rd
Saint James, NY 11780-1414
Phone
(631) 951-7776
Fax
(631) 382-8324
NPI assigned
Jan 23, 2018
Last updated
Apr 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2020

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

Authorized official

Name
Mrs. Jillian Lynn Milin, MSPTNPI 1033545736
Title
Owner
Phone
(631) 951-7776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0329931 NY Primary

Addresses

Primary practice location

33 Great Oak Rd
Saint James, NY 11780-1414

Mailing address

33 Great Oak Rd
Saint James, NY 11780-1414
Phone (631) 951-7776

Other identifiers 1

IdentifierTypeStateIssuer
AS87MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180221000988 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8426319161 Receives reassigned benefits from 11 practitioners
Practice locations: Saint James, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586649600000",
    "number": "1356849491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 GREAT OAK RD",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117801414",
            "telephone_number": "631-951-7776",
            "fax_number": "631-382-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 GREAT OAK RD",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117801414",
            "telephone_number": "631-951-7776",
            "fax_number": "631-382-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERGIZE HOME PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2020-04-12",
        "certification_date": "2020-04-12",
        "status": "A",
        "authorized_official_last_name": "MILIN",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-951-7776",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0329931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AS87",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint James, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2020; 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.