Individual provider Active NPI

Brian Anthony Herrera, DPT, MSPT

  • Physical Therapist
  • Manhasset, NY
National Provider Identifier
1376593855
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023499 Issued in NY
Practice address
50 Maple PL
Manhasset, NY 11030-1927
Phone
(516) 682-8560
Fax
(516) 682-8562
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 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 023499 NY Primary

Addresses

Primary practice location

50 Maple PL
Manhasset, NY 11030-1927

Mailing address

27 Badger Rd
Suite 103
Manorville, NY 11949-3201
Phone (516) 682-8560

Other practice location 1

715 Roanoke Ave
Riverhead, NY 11901-2769
Phone (631) 475-1224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060828000491 NY Practitioner - Physical Therapist in Private Practice 5698779973 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023499NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Assoc of Long Island Physicians & Medical Group PLLC CurrentSince Jun 21, 2021 Accepting new patients
Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC Physical Therapist CurrentSince Apr 1, 2014 Accepting new patients
Orthopedic Assoc of Long Island Physicians & Medical Group PLLC CurrentSince Jun 21, 2021 Accepting new patients
Sherrie Glasser, Physical Therapist. PC Physical Therapist Past Accepting new patients

Locations

285 Sills Rd
Bldg 5-6B
East Patchogue, NY 11772
Phone (631) 475-2858

6 Technology Dr
Ste 100
East Setauket, NY 11733
Phone (631) 371-2685

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1376593855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 BADGER RD",
            "address_2": "SUITE 103",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119493201",
            "telephone_number": "516-682-8560",
            "fax_number": "516-682-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MAPLE PL",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110301927",
            "telephone_number": "516-682-8560",
            "fax_number": "516-682-8562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Roanoke Ave",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "119012769",
            "country_code": "US",
            "telephone_number": "631-475-1224",
            "fax_number": "631-475-1588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "BRIAN",
        "middle_name": "ANTHONY",
        "credential": "DPT, MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.