Individual provider Active NPI

Robert Issing, PT,DPT

  • Physical Therapist
  • Bay Shore, NY
National Provider Identifier
1407493620
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
038429 Issued in NY
Practice address
301 E Main St
Bay Shore, NY 11706-8408
Phone
(631) 968-3400
NPI assigned
Dec 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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 038429 NY Primary

Addresses

Primary practice location

301 E Main St
Bay Shore, NY 11706-8408

Mailing address

844 Densfield Rd
West Babylon, NY 11704-7137
Phone (631) 807-5400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801000988 NY Practitioner - Physical Therapist in Private Practice 2163969726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Jun 24, 2024 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jun 24, 2024 Accepting new patients

Locations

79 Deer Park Ave
Babylon, NY 11702
Phone (631) 587-0574

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1407493620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 DENSFIELD RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117047137",
            "telephone_number": "631-807-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-968-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISSING",
        "first_name": "ROBERT",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-06",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "038429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.