Active NPI
Neil Obeso, DPT
- Physical Therapist
- Stony Brook, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 046604-01
- Practice address
- 97 Main St Ste H
Stony Brook, NY 11790-1900 - Phone
- (631) 751-6680
- NPI assigned
- Dec 2, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 046604-01 | NY | Primary |
Addresses
Primary practice location
97 Main St Ste H
Stony Brook, NY 11790-1900
Mailing address
190 Sound Beach Blvd
Sound Beach, NY 11789-1644
Phone (631) 413-1757
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9525 Queens Blvd
Suite 3D
Rego Park, NY 11374-4510
Phone (718) 925-6212
Merit-based Incentive Payment System (MIPS)
- Final score
- 77.16 of 100
- Quality
- 70
- Improvement activities
- 40
- Cost
- 78.87
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046604-01 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Latitude Physical Therapy | Physical Therapist | Current | Accepting new patients |
| Sports Physical Therapy Occupational Therapy and Rehabilitation Servic | Current | Accepting new patients | |
| Kah Premium Physical Therapy P.C. | Physical Therapist | Current | Accepting new patients |
| Sports Physical Therapy Occupational Therapy and Rehabilitation Servic | Physical Therapist | Current | Accepting new patients |
Locations
50 E 42nd St
Rm 702
New York, NY 10017
Phone (212) 470-2735
9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212
34 Bay St
#205206
Sag Harbor, NY 11963
Phone (631) 919-5189
97 Main St
Ste H
Stony Brook, NY 11790
Phone (631) 751-6680
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 and National Provider Directory roles.
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- Hand Physical Therapist
- East Meadow, NY
- NPI 1770540593
-
- Physical Therapist
- Stony Brook, NY
- NPI 1922396373
-
- Physical Therapist
- Sag Harbor, NY
- NPI 1326816992
-
- Occupational Therapist
- White Plains, NY
- NPI 1629825591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1437754942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 SOUND BEACH BLVD",
"city": "SOUND BEACH",
"state": "NY",
"postal_code": "117891644",
"telephone_number": "631-413-1757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "97 MAIN ST STE H",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117901900",
"telephone_number": "631-751-6680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBESO",
"first_name": "NEIL",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-02",
"last_updated": "2020-12-02",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "046604-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.