Individual provider Active NPI

Justin Simone

  • Physical Therapist
  • Mamaroneck, NY
National Provider Identifier
1548637416
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039213-01 Issued in NY
Practice address
1053 W Boston Post Rd
Mamaroneck, NY 10543-3329
Phone
(914) 381-0203
NPI assigned
Aug 27, 2015
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01799600 NJ
Physical Therapist 225100000X 039213-01 NY Primary

Addresses

Primary practice location

1053 W Boston Post Rd
Mamaroneck, NY 10543-3329

Mailing address

48 S Franklin Tpke
Ste 101
Ramsey, NJ 07446-2558
Phone (718) 767-0610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151020002736 NY Practitioner - Physical Therapist in Private Practice 9537478243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

1086 Bdway
Yonkers, NY 10701-1112
Phone (914) 771-9666

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

3611 E Tremont Ave
Bronx, NY 10465-2053
Phone (718) 904-9581

88 Ashford Ave
Dobbs Ferry, NY 10522-1812
Phone (845) 271-7400

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039213-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Progressive Spine & Sports Medicine PastSince Jul 23, 2018 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1250 Waters Pl
Ste 501
Bronx, NY 10461
Phone (718) 319-1740

1086 N Broadway
Ste 200
Yonkers, NY 10701
Phone (914) 771-9666

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 3

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": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1548637416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 S FRANKLIN TPKE",
            "address_2": "STE 101",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074462558",
            "telephone_number": "718-767-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 W BOSTON POST RD",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105433329",
            "telephone_number": "914-381-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONE",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01799600",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039213-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mamaroneck, 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.