Individual provider Active NPI

Gregory Diem

  • Physical Therapist
  • Manhasset, NY
National Provider Identifier
1457086159
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1170 Northern Blvd
Manhasset, NY 11030-3018
Phone
(516) 684-1122
Fax
(516) 684-1123
NPI assigned
Jul 18, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 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 NY Primary

Addresses

Primary practice location

1170 Northern Blvd
Manhasset, NY 11030-3018

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912003412 NJ Practitioner - Physical Therapist in Private Practice 0446629968 Reassigns benefits to 1 organization

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
Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

1 Greenwood Ave
Montclair, NJ 07042-3649
Phone (973) 746-2424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Nov 14, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Nov 14, 2022 Accepting new patients

Locations

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

1170 Northern Blvd
Manhasset, NY 11030
Phone (516) 684-1122

576 Broadhollow Rd
Melville, NY 11747

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 5

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": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1457086159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 NORTHERN BLVD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303018",
            "telephone_number": "516-684-1122",
            "fax_number": "516-684-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEM",
        "first_name": "GREGORY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.