NPIMap

Organization Active NPI

Island Sports Physiotherapy, PC

  • Physical Therapy Clinic/Center
  • East Northport, NY
National Provider Identifier
1366482408
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ISLAND SPORTS PHYSIOTHERAPY, PC
Practice address
1937 Jericho Tpke
East Northport, NY 11731-6208
Phone
(631) 462-9595
Fax
(631) 462-9613
NPI assigned
Jun 7, 2006
Last updated
Oct 16, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
ISLAND SPORTS PHYSIOTHERAPY, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Keith A. May, P.T.NPI 1821034414
Title
President
Phone
(631) 462-9595

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1937 Jericho Tpke
East Northport, NY 11731-6208

Mailing address

1937 Jericho Tpke
East Northport, NY 11731-6208
Phone (631) 462-9595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090521000077 NY Part B Supplier - Clinic/Group Practice 4082503040 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: East Northport, NY; Huntington, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Island Sports Physiotherapy2 organizations share this tax ID, including this one
Part of
Island Sports Physiotherapy

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

18627 Brookhurst St
#313
Fountain Valley, CA 92708

3072 Jericho Tpke
East Northport, NY 11731
Phone (631) 462-9595

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1366482408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 JERICHO TPKE",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117316208",
            "telephone_number": "631-462-9595",
            "fax_number": "631-462-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1937 JERICHO TPKE",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117316208",
            "telephone_number": "631-462-9595",
            "fax_number": "631-462-9613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND SPORTS PHYSIOTHERAPY, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ISLAND SPORTS PHYSIOTHERAPY, PC",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "MAY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-462-9595",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.