Michael Scottodimaso

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012945-01 Issued in NY

Practice address

51 John St Ste 3
Babylon, NY 11702-2928

Phone

(631) 669-0333

Fax

(631) 669-2436

NPI assigned

Dec 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael Scottodimaso, PT, PLLCGroup PAC ID 7810050051, 2 clinicians

Raymond N Cecora PT PCGroup PAC ID 6002889946, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Michael Scottodimaso and Tara Derosa, PT, OT, PLLC

  • Physical Therapist
  • Babylon, NY
  • NPI 1154575074
  Medicare reassignment Care Compare group NPD Authorized official
• Raymond N Cecora PT PC

  • Physical Therapist
  • Massapequa, NY
  • NPI 1366506461
  Medicare reassignment Care Compare group
• Bienetre Medical PC

  • Physical Therapist
  • New York, NY
  • NPI 1568037257
  Medicare reassignment NPD

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1497937056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 JOHN ST",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117022928",
            "telephone_number": "631-669-0333",
            "fax_number": "631-669-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 JOHN ST STE 3",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117022928",
            "telephone_number": "631-669-0333",
            "fax_number": "631-669-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTTODIMASO",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "012945",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012945-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth J Schwartz, LCSW-R
• Krystal Sciascia, PT
• Melanie Jean Scola, L.AC.
• Kim Suzanne Sconzo
• Kathleen Marie Scott, LPN
• Lynn A Segerivas, FNP
• Serenity Therapy & Wellness LCSW PLLC
• Shabeer a Dar M.D.P.C.
• Craig Shalmi, M.D.
• John W. Shamul, DDS

• Physical Therapist in Babylon, NY
• Providers in Babylon, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.