Individual provider Active NPI

Michelle L Farella-Accurso, PT

  • Physical Therapist
  • Old Westbury, NY
National Provider Identifier
1417948324
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20151-1 Issued in NY
Practice address
Northern Blvd
Academic Health Care Center, Ny Institute of Technology
Old Westbury, NY 11568-8000
Phone
(516) 686-1300
Fax
(516) 686-7890
NPI assigned
Oct 31, 2005
Last updated
Jun 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 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 20151-1 NY Primary

Addresses

Primary practice location

Northern Blvd
Academic Health Care Center, Ny Institute of Technology
Old Westbury, NY 11568-8000

Mailing address

Northern Blvd
Academic Health Care Center, Ny Institute of Technology
Old Westbury, NY 11568-8000
Phone (516) 686-1300

Other identifiers 2

IdentifierTypeStateIssuer
1821048612OtherNYGROUP NPI NUMBER
1417948324OtherNYNPI NUMBER

Other names 1

  • Michelle L Farella Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040622001131 NY Practitioner - Physical Therapist in Private Practice 1052396199 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20151-1NYMDPhysical Therapist
020151NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Physical Therapy Services LLC Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
New York Institute of Technology CurrentSince Oct 1, 1998 Accepting new patients
New York Institute of Technology Physical Therapist CurrentSince Oct 1, 1998 Accepting new patients
New York Institute of Technology Current Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

267 Carleton Ave
Central Islip, NY 11722
Phone (631) 348-3254

600 Northern Blvd
Greenvale, NY 11548
Phone (516) 686-3849

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

Organizations & group practices 4

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1417948324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTHERN BLVD",
            "address_2": "ACADEMIC HEALTH CARE CENTER, NY INSTITUTE OF TECHNOLOGY",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115688000",
            "telephone_number": "516-686-1300",
            "fax_number": "516-686-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTHERN BLVD",
            "address_2": "ACADEMIC HEALTH CARE CENTER, NY INSTITUTE OF TECHNOLOGY",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115688000",
            "telephone_number": "516-686-1300",
            "fax_number": "516-686-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARELLA-ACCURSO",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "20151-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1821048612",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1417948324",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "FARELLA",
            "middle_name": "L",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Old Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.