Individual provider Active NPI

Torin Bacon

  • Physical Therapist
  • Lynbrook, NY
National Provider Identifier
1497320824
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
225 Merrick Rd
Lynbrook, NY 11563-2621
Phone
(516) 599-8734
NPI assigned
May 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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 Primary

Addresses

Primary practice location

225 Merrick Rd
Lynbrook, NY 11563-2621

Mailing address

PO Box 416501
Boston, MA 02241-6501
Phone (914) 294-4050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211210002081 NY Practitioner - Physical Therapist in Private Practice 1153711882 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048083NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Nov 19, 2021 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Nov 19, 2021 Accepting new patients

Locations

1063 Willis Ave
Albertson, NY 11507
Phone (516) 656-7776

939 Atlantic Ave
Baldwin, NY 11510
Phone (516) 517-0404

214 Glen Cove Ave
Glen Cove, NY 11542
Phone (516) 268-3555

550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737

3961 Long Beach Rd
Island Park, NY 11558
Phone (516) 599-8734

225 Merrick Rd
Lynbrook, NY 11563
Phone (516) 599-8734

1730 Lakeville Rd
New Hyde Park, NY 11040
Phone (516) 326-4580

389 Fort Salonga Rd
Northport, NY 11768
Phone (631) 261-0444

57 Old Shore Rd
Port Washington, NY 11050
Phone (516) 464-7959

1169 Wantagh Ave
Wantagh, NY 11793
Phone (516) 785-4800

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Organizations & group practices 7

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.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Physical Therapy, Occupational Therapy and Speech Language PA 385 clinicians

Practice addresses (Care Compare)

3961 Long Beach Rd
Island Park, NY 11558-1127
Phone (516) 897-9700

Merit-based Incentive Payment System (MIPS)

Final score
82.23 of 100Reported as individual
Quality
79.1
Improvement activities
40

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1497320824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416501",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416501",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MERRICK RD",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632621",
            "telephone_number": "516-599-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "TORIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.