Active NPI
Benjamin D Darragh Jr., DPT
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1376214619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 047794
- Practice address
- 476 Gates Ave Apt 2F
Brooklyn, NY 11216-6683 - Phone
- (972) 754-8063
- NPI assigned
- Sep 27, 2021
- Last updated
- Sep 27, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 047794 | Other | NY | NEW YORK STATE LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rock Rehab of Massachusetts LLC | Physical Therapist | Current | 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.