Individual provider Active NPI

Madeline Nicole O'Shaughnessy, DR

  • Physical Therapist
  • Port Jefferson Station, NY
National Provider Identifier
1457071185
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
049073 Issued in NY
Practice address
1500 Ny-112
Building 9
Port Jefferson Station, NY 11776
Phone
(631) 849-6688
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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 049073 NY Primary

Addresses

Primary practice location

1500 Ny-112
Building 9
Port Jefferson Station, NY 11776

Mailing address

1 Home Dr
Medford, NY 11763-4002
Phone (631) 316-4734

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220923000552 NY Practitioner - Physical Therapist in Private Practice 1557746765 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

679 Whiskey Rd
Ridge, NY 11961-8352
Phone (631) 821-8090

Merit-based Incentive Payment System (MIPS)

Final score
77.35 of 100Reported as group
Quality
73.31
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049073NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Aug 11, 2022 Accepting new patients

Locations

4080 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 738-4844

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

1500 Route 112
Bldg 9
Port Jefferson Station, NY 11776
Phone (631) 849-6688

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

679 Whiskey Rd
Ridge, NY 11961
Phone (631) 821-4313

745 Route 25A
Rocky Point, NY 11778
Phone (516) 457-6387

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": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1457071185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOME DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634002",
            "telephone_number": "631-316-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 NY-112",
            "address_2": "BUILDING 9",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-849-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHAUGHNESSY",
        "first_name": "MADELINE",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "DR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.

Verify at the official NPI Registry.