Organization Active NPI

Modern Rehabilitation Technologies, LLC

  • Prosthetic/Orthotic Supplier
  • Holbrook, NY
National Provider Identifier
1407030505
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MODERN REHABILITATION TECHNOLOGIES, LLC
Practice address
1180 Lincoln Avenue
Unit 4
Holbrook, NY 11741
Phone
(631) 360-6400
Fax
(631) 360-6449
NPI assigned
Dec 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Authorized official

Name
William M Schwing, CPO
Title
Owner
Phone
(631) 360-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1180 Lincoln Avenue
Unit 4
Holbrook, NY 11741

Mailing address

1180 Lincoln Avenue
Unit 4
Holbrook, NY 11741
Phone (631) 360-6400

Other identifiers 1

IdentifierTypeStateIssuer
02192501MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930079236 NY DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 7517079122 Practice locations: Holbrook, NY

National Provider Directory

National Provider Directory
Tax ID family
Modern Rehabilitation Technologies LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

431 E Main St
Ste 2
Denville, NJ 07834
Phone (973) 784-4286

Practitioners & affiliated clinicians

Practitioners 1

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": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386892800000",
    "number": "1407030505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 LINCOLN AVENUE",
            "address_2": "UNIT 4",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "11741",
            "telephone_number": "631-360-6400",
            "fax_number": "631-360-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 LINCOLN AVENUE",
            "address_2": "UNIT 4",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "11741",
            "telephone_number": "631-360-6400",
            "fax_number": "631-360-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN REHABILITATION TECHNOLOGIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2013-12-13",
        "status": "A",
        "authorized_official_last_name": "SCHWING",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-360-6400",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02192501",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.