Derek Bershad, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

042950-1 Issued in NY

Practice address

2848 Middle Country Rd
Lake Grove, NY 11755-2104

Phone

(631) 780-5550

Fax

(631) 285-2124

NPI assigned

May 15, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Massapequa PT and Pta PLLCGroup PAC ID 4385828797, 5 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.

• Massapequa PT & Pta PLLC

  • Physical Therapist
  • N Massapequa, NY
  • NPI 1316246895
  Medicare reassignment Care Compare group
• Home-Based Physical Therapy PLLC

  • Physical Therapist
  • Woodmere, NY
  • NPI 1356900989
  Medicare reassignment NPD
• Peyman Younesi MD PLLC

  • Internal Medicine Physician
  • Fresh Meadows, NY
  • NPI 1891053328
  Medicare reassignment NPD
• K & H Medical PLLC

  • Vascular & Interventional Radiology Physician
  • Bethpage, NY
  • NPI 1518458751
  NPD (past)
• Metro Care Providers PT, PLLC

  • Physical Therapist
  • Woodmere, NY
  • NPI 1639959919
  NPD (past)

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1578053526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 HAMILTON PL",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551915",
            "telephone_number": "631-780-5550",
            "fax_number": "631-285-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2848 MIDDLE COUNTRY RD",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552104",
            "telephone_number": "631-780-5550",
            "fax_number": "631-285-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSHAD",
        "first_name": "DEREK",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042950-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Becker
• Joseph Daniel Bello
• Suzanne D Belmonte, MS, CCC-SLP, TSSLD
• Evan Keith Bernstein, DC
• Patricia Bernstein, N.P.P.
• Melissa Ann Biamonte, OT REGISTERED
• Jacques S. J. Blanchard, D.P.T.,
• Marcia Blatt, MA
• Robert Joseph Boswell, MD
• Mario Brajuha, LMSW

• Physical Therapist in Lake Grove, NY
• Providers in Lake Grove, 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 May 17, 2018; 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.