Active NPI
Gregory Reardon, DPT, CSCS
- Physical Therapist
- Manhasset, NY
National Provider Identifier
1407274145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0365545-1
- Practice address
- 1554 Northern Blvd
Manhasset, NY 11030-3006 - Phone
- (516) 627-8470
- NPI assigned
- Mar 31, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0365545-1 | NY | Primary |
Addresses
Primary practice location
1554 Northern Blvd
Manhasset, NY 11030-3006
Mailing address
1554 Northern Blvd
Manhasset, NY 11030-3006
Phone (516) 627-8470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0365545-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reardon Physical Therapy, PLLC | Current | Accepting new patients |
Organizations & group practices 1
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.
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- Islip, NY
- NPI 1699287789
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396224000000",
"number": "1407274145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1554 NORTHERN BLVD",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110303006",
"telephone_number": "516-627-8470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1554 NORTHERN BLVD",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110303006",
"telephone_number": "516-627-8470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "DPT, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-31",
"last_updated": "2014-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "0365545-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhasset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.