NPIMap

Organization Active NPI

Farmingdale Physical Therapy East LLC

  • Physical Therapist
  • Farmingdale, NY
National Provider Identifier
1376842658
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006358-1 Issued in NY
Legal business name
FARMINGDALE PHYSICAL THERAPY EAST LLC
Practice address
326 Main St
Farmingdale, NY 11735-3507
Phone
(516) 293-0565
Fax
(516) 293-1897
NPI assigned
Mar 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

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

Authorized official

Name
John C Dugan, PT OCS NCS GCSNPI 1841279817
Title
President
Phone
(516) 293-0565

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 006358-1 NY Primary

Addresses

Primary practice location

326 Main St
Farmingdale, NY 11735-3507

Mailing address

326 Main St
Farmingdale, NY 11735-3507
Phone (516) 293-0565

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110607000202 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3870770589 Receives reassigned benefits from 3 practitioners
Practice locations: Farmingdale, NY; Massapequa, NY

National Provider Directory

National Provider Directory

Locations

326 Main St
Farmingdale, NY 11735
Phone (516) 293-0565

97 Grand Ave
Massapequa, NY 11758
Phone (516) 293-0565

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1376842658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 MAIN ST",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353507",
            "telephone_number": "516-293-0565",
            "fax_number": "516-293-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 MAIN ST",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353507",
            "telephone_number": "516-293-0565",
            "fax_number": "516-293-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMINGDALE PHYSICAL THERAPY EAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-25",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "DUGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-293-0565",
        "authorized_official_credential": "PT OCS NCS GCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "006358-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.