Individual provider Active NPI

Benjamin D Darragh Jr., DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1376214619
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047794 Issued in NY
Practice address
476 Gates Ave Apt 2F
Brooklyn, NY 11216-6683
Phone
(972) 754-8063
NPI assigned
Sep 27, 2021
Last updated
Sep 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 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 047794 NY Primary

Addresses

Primary practice location

476 Gates Ave Apt 2F
Brooklyn, NY 11216-6683

Mailing address

476 Gates Ave Apt 2F
Brooklyn, NY 11216-6683
Phone (972) 754-8063

Other identifiers 1

IdentifierTypeStateIssuer
047794OtherNYNEW YORK STATE LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241216002722 MA Practitioner - Physical Therapist in Private Practice 5799182036 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Rehab of Massachusetts LLC Physical Therapist CurrentSince Nov 20, 2024 Accepting new patients

Locations

68 Harrison Ave
Ste 605
Boston, MA 02111
Phone (508) 500-6720

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1376214619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "476 GATES AVE APT 2F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112166683",
            "telephone_number": "972-754-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 GATES AVE APT 2F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112166683",
            "telephone_number": "972-754-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARRAGH",
        "first_name": "BENJAMIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE LICENSE NUMBER",
            "identifier": "047794",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.