Individual provider Active NPI

Vance Wernert

  • Physical Therapist
  • Island Park, NY
National Provider Identifier
1356857460
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
042106 Issued in NY
Practice address
3961 Long Beach Rd
Island Park, NY 11558-1127
Phone
(516) 599-8734
NPI assigned
Dec 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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 042106 NY Primary

Addresses

Primary practice location

3961 Long Beach Rd
Island Park, NY 11558-1127

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Other practice location 1

3480 Veterans Memorial Hwy
Bohemia, NY 11716-1068
Phone (516) 536-3800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180306002036 NY Practitioner - Physical Therapist in Private Practice 3375804446 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3961 Long Beach Rd
Island Park, NY 11558-1127
Phone (516) 897-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical Group PC CurrentSince Jan 1, 2018 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Sep 20, 2021 Accepting new patients
True North Medical Group PC Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Sep 20, 2021 Accepting new patients

Locations

1063 Willis Ave
Albertson, NY 11507
Phone (516) 656-7776

939 Atlantic Ave
Baldwin, NY 11510
Phone (516) 517-0404

3480 Veterans Memorial Hwy
Bohemia, NY 11716
Phone (631) 289-0338

194 New Hyde Park Rd
Franklin Square, NY 11010
Phone (516) 738-5599

550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737

3961 Long Beach Rd
Island Park, NY 11558
Phone (516) 599-8734

444 Merrick Rd
Lynbrook, NY 11563
Phone (516) 536-3800

225 Merrick Rd
Lynbrook, NY 11563
Phone (516) 599-8734

1730 Lakeville Rd
New Hyde Park, NY 11040
Phone (516) 326-4580

389 Fort Salonga Rd
Northport, NY 11768
Phone (631) 261-0444

57 Old Shore Rd
Port Washington, NY 11050
Phone (516) 464-7959

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

1169 Wantagh Ave
Wantagh, NY 11793
Phone (516) 785-4800

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

45 Crossways Park Dr W
Woodbury, NY 11797
Phone (516) 422-8080

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1356857460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3961 LONG BEACH RD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581127",
            "telephone_number": "516-599-8734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3480 Veterans Memorial Hwy",
            "address_purpose": "LOCATION",
            "city": "Bohemia",
            "state": "NY",
            "postal_code": "117161068",
            "country_code": "US",
            "telephone_number": "516-536-3800",
            "fax_number": "516-992-4637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WERNERT",
        "first_name": "VANCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-27",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Island Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.

Verify at the official NPI Registry.