Individual provider Active NPI

Barry Root, MD

  • Physical Medicine & Rehabilitation Physician
  • Glen Cove, NY
National Provider Identifier
1376603456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A167868 Issued in NY
Practice address
Glen Cove Hospital Dept of PM and R
101 St. Andrews Lane
Glen Cove, NY 11542
Phone
(516) 674-7500
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A167868 NY Primary

Addresses

Primary practice location

Glen Cove Hospital Dept of PM and R
101 St. Andrews Lane
Glen Cove, NY 11542

Mailing address

Glen Cove Hospital Dept of PM and R
101 St. Andrews Lane
Glen Cove, NY 11542
Phone (516) 674-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071130000060 NY Practitioner - Physical Medicine and Rehabilitation 0143318931 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A167868NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakov Raufov Medical PC CurrentSince Jan 1, 2016 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Past Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Past Accepting new patients

Locations

1701 Quentin Rd
Ste A7
Brooklyn, NY 11229
Phone (718) 339-4448

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

100 Community Dr
Great Neck, NY 11021
Phone (516) 365-1805

146 Birch Hill Rd
Locust Valley, NY 11560
Phone (516) 723-9305

9830 67th Ave
Ste Gg
Rego Park, NY 11374
Phone (718) 339-4448

1 Expressway Plz
Ste 100
Roslyn Heights, NY 11577
Phone (516) 299-4540

Organizations & group practices 3

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376603456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GLEN COVE HOSPITAL DEPT OF PM AND R",
            "address_2": "101 ST. ANDREWS LANE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "11542",
            "telephone_number": "516-674-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GLEN COVE HOSPITAL DEPT OF PM AND R",
            "address_2": "101 ST. ANDREWS LANE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "11542",
            "telephone_number": "516-674-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "BARRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "A167868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.