NPIMap

Organization Active NPI

Chris Prentiss Physical Therapy PC

  • Specialist
  • Commack, NY
National Provider Identifier
1548543044
Registry record updated Sep 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CHRIS PRENTISS PHYSICAL THERAPY PC
Practice address
763 Larkfield Rd
Suite 101
Commack, NY 11725-3131
Phone
(631) 462-0118
Fax
(631) 462-0827
NPI assigned
Sep 21, 2011
Last updated
Sep 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2011

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

Authorized official

Name
R Chris Prentiss, PT,OCS,CERTMDT,CSCSNPI 1073591764
Title
Owner
Phone
(631) 462-0118

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
Specialist 174400000X NY Primary

Addresses

Primary practice location

763 Larkfield Rd
Suite 101
Commack, NY 11725-3131

Mailing address

763 Larkfield Rd
Suite 101
Commack, NY 11725-3131
Phone (631) 462-0118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111229000026 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2466628284 Receives reassigned benefits from 1 practitioner
Practice locations: Commack, NY

National Provider Directory

National Provider Directory

Locations

763 Larkfield Rd
Ste 101
Commack, NY 11725
Phone (631) 462-0118

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316822400000",
    "number": "1548543044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 LARKFIELD RD",
            "address_2": "SUITE 101",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253131",
            "telephone_number": "631-462-0118",
            "fax_number": "631-462-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 LARKFIELD RD",
            "address_2": "SUITE 101",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253131",
            "telephone_number": "631-462-0118",
            "fax_number": "631-462-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIS PRENTISS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-24",
        "status": "A",
        "authorized_official_last_name": "PRENTISS",
        "authorized_official_first_name": "R",
        "authorized_official_middle_name": "CHRIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-462-0118",
        "authorized_official_credential": "PT,OCS,CERTMDT,CSCS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2011; 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.