Active NPI
Ryan Echavarria, PTA
- Physical Therapy Assistant
- East Setauket, NY
National Provider Identifier
1578282257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 013351
- Practice address
- 318 Sheep Pasture Rd
East Setauket, NY 11733-3611 - Phone
- (631) 879-8455
- NPI assigned
- Aug 25, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 013351 | NY | Primary |
Addresses
Primary practice location
318 Sheep Pasture Rd
East Setauket, NY 11733-3611
Mailing address
318 Sheep Pasture Rd
East Setauket, NY 11733-3611
Other practice location 1
110 Beaver Dam Rd
Brookhaven, NY 11719-9719
Phone (631) 286-8100
Other practice location 2
299 Hallock Ave
Port Jefferson Station, NY 11776-1217
Phone (631) 473-4284
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013351 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1578282257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 SHEEP PASTURE RD",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "117333611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 SHEEP PASTURE RD",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "117333611",
"telephone_number": "631-879-8455"
}
],
"practiceLocations": [
{
"address_1": "110 Beaver Dam Rd",
"address_purpose": "LOCATION",
"city": "Brookhaven",
"state": "NY",
"postal_code": "117199719",
"country_code": "US",
"telephone_number": "631-286-8100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "299 Hallock Ave",
"address_purpose": "LOCATION",
"city": "Port Jefferson Station",
"state": "NY",
"postal_code": "117761217",
"country_code": "US",
"telephone_number": "631-473-4284",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ECHAVARRIA",
"first_name": "RYAN",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-25",
"last_updated": "2022-08-25",
"certification_date": "2022-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "013351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Setauket, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.