NPIMap

Organization Active NPI

Evolution Home Physical Therapy, P.C.

  • Physical Therapist
  • Port Jefferson, NY
National Provider Identifier
1477564599
Registry record updated Oct 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EVOLUTION HOME PHYSICAL THERAPY, P.C.
Practice address
7 Waterview Dr
Port Jefferson, NY 11777-1169
Phone
(631) 513-9475
Fax
(631) 689-5828
NPI assigned
Aug 11, 2006
Last updated
Oct 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2023

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

Authorized official

Name
Dr. Scott Richard Lindsay, PT, DPTNPI 1205847308
Title
Director
Phone
(631) 513-9475

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: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

7 Waterview Dr
Port Jefferson, NY 11777-1169

Mailing address

7 Waterview Dr
Port Jefferson, NY 11777-1169
Phone (631) 513-9475

Other practice location 1

12 Platinum Ct
Medford, NY 11763-2247
Phone (631) 320-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060223000343 NY Part B Supplier - Clinic/Group Practice 5092721381 Receives reassigned benefits from 11 practitioners
Practice locations: Port Jefferson, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698537600000",
    "number": "1477564599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WATERVIEW DR",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771169",
            "telephone_number": "631-513-9475",
            "fax_number": "631-689-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WATERVIEW DR",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771169",
            "telephone_number": "631-513-9475",
            "fax_number": "631-689-5828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Platinum Ct",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NY",
            "postal_code": "117632247",
            "country_code": "US",
            "telephone_number": "631-320-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVOLUTION HOME PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-10-29",
        "certification_date": "2023-10-29",
        "status": "A",
        "authorized_official_last_name": "LINDSAY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-513-9475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2023; 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.