Individual provider Active NPI

Gary L Foster, PT

  • Specialist
  • Smithtown, NY
National Provider Identifier
1386675080
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0162251 Issued in NY
Practice address
222 E Main St
Suite 340
Smithtown, NY 11787-2871
Phone
(631) 366-3025
Fax
(631) 366-3026
NPI assigned
Jul 5, 2006
Last updated
Feb 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0162251 NY Primary

Addresses

Primary practice location

222 E Main St
Suite 340
Smithtown, NY 11787-2871

Mailing address

222 E Main St
Suite 340
Smithtown, NY 11787-2871
Phone (631) 366-3025

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060711000041 NY Practitioner - Physical Therapist in Private Practice 8022021252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beach and Foster Physical Therapy, P.C.Group PAC ID 2769495613, 2 clinicians

Practice addresses (Care Compare)

1092 Jericho Tpke
Commack, NY 11725-3016

1092 W Jericho Tpke
Commack, NY 11725-3016
Phone (631) 366-3025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0162251NYMDSpecialist
016225NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beach & Foster Physical Therapy, P.C. Specialist CurrentSince May 1, 2006 Accepting new patients
Michael Scottodimaso and Tara Derosa, PT, OT, PLLC Past Accepting new patients
Beach Physical Therapy, PC Past Accepting new patients

Locations

1092 Jericho Tpke
Commack, NY 11725
Phone (631) 360-6370

222 E Middle Country Rd
Ste 340
Smithtown, NY 11787
Phone (631) 366-3025

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, 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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1386675080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E MAIN ST",
            "address_2": "SUITE 340",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872871",
            "telephone_number": "631-366-3025",
            "fax_number": "631-366-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E MAIN ST",
            "address_2": "SUITE 340",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872871",
            "telephone_number": "631-366-3025",
            "fax_number": "631-366-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "GARY",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "0162251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.