Organization Active NPI

True Potential Physical Therapy P.C.

  • Physical Therapist
  • Bayport, NY
National Provider Identifier
1447728118
Registry record updated Jun 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TRUE POTENTIAL PHYSICAL THERAPY P.C.
Practice address
899 Montauk Hwy
Bayport, NY 11705-1613
Phone
(516) 658-2837
NPI assigned
Nov 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2020

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

Authorized official

Name
Michael DagroNPI 1659761617
Title
Doctor of Physical Therapy
Phone
(516) 658-2837

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

899 Montauk Hwy
Bayport, NY 11705-1613

Mailing address

899 Montauk Hwy
Bayport, NY 11705-1613
Phone (631) 823-0600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190702001306 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4284975475 Receives reassigned benefits from 2 practitioners
Practice locations: Bayport, NY

National Provider Directory

National Provider Directory

Locations

899 Montauk Hwy
Bayport, NY 11705
Phone (516) 658-2837

Practitioners & affiliated clinicians

Practitioners 2

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": "1541894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593302400000",
    "number": "1447728118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 MONTAUK HWY",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051613",
            "telephone_number": "631-823-0600",
            "fax_number": "631-823-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 MONTAUK HWY",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051613",
            "telephone_number": "516-658-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUE POTENTIAL PHYSICAL THERAPY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-11",
        "last_updated": "2020-06-28",
        "certification_date": "2020-06-28",
        "status": "A",
        "authorized_official_last_name": "DAGRO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "516-658-2837"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.