Individual provider Active NPI

Aderemi Isola Adeyemi, P.T.

  • Physical Therapist
  • Rockaway Beach, NY
National Provider Identifier
1386818128
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013123 Issued in NY
Practice address
214 Beach 92ND St
1
Rockaway Beach, NY 11693-1540
Phone
(718) 634-3727
Fax
(718) 835-5008
NPI assigned
Apr 14, 2008
Last updated
Apr 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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 013123 NY Primary

Addresses

Primary practice location

214 Beach 92ND St
1
Rockaway Beach, NY 11693-1540

Mailing address

214 Beach 92ND St
Apt 1
Rockaway Beach, NY 11693-1540
Phone (718) 634-3727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080716000552 NY Practitioner - Physical Therapist in Private Practice 1658444153 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Long IslandGroup PAC ID 7315835907, 43 clinicians
Epic Medical Services PCGroup PAC ID 8628365582, 27 clinicians
Global SLP OT PT and Psychological Services PLLCGroup PAC ID 1658781489, 9 clinicians

Practice addresses (Care Compare)

1500 Hempstead Tpke
East Meadow, NY 11554-1551
Phone 5167397733420

1979 Marcus Ave
Suite 204
New Hyde Park, NY 11042-1002
Phone (516) 327-4681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013123NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Medical Services PC CurrentSince Apr 1, 2016 Accepting new patients
Lifespire, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Epic Long Island CurrentSince Mar 11, 2016 Accepting new patients
Epilepsy Foundation of L.I. CurrentSince Mar 11, 2016 Accepting new patients
Lifespire, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Global SLP OT PT & Psychological Services, PLLC Physical Therapist CurrentSince Jan 1, 2021 Accepting new patients

Locations

21301 Northern Blvd
Fl 2
Bayside, NY 11361
Phone (718) 721-5444

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

16210 Jamaica Ave
Ste 7
Jamaica, NY 11432
Phone (718) 454-2700

1979 Marcus Ave
Ste 204
New Hyde Park, NY 11042
Phone (516) 327-4681

159 E 125th St
Fl 2
New York, NY 10035
Phone (212) 360-5600

Organizations & group practices 6

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": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1386818128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BEACH 92ND ST",
            "address_2": "APT 1",
            "city": "ROCKAWAY BEACH",
            "state": "NY",
            "postal_code": "116931540",
            "telephone_number": "718-634-3727",
            "fax_number": "718-835-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BEACH 92ND ST",
            "address_2": "1",
            "city": "ROCKAWAY BEACH",
            "state": "NY",
            "postal_code": "116931540",
            "telephone_number": "718-634-3727",
            "fax_number": "718-835-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEYEMI",
        "first_name": "ADEREMI",
        "middle_name": "ISOLA",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockaway Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.