Ralph Licciardi, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

052989 Issued in NY

Practice address

146 Birch Hill Rd
Locust Valley, NY 11560-1833

Phone

(516) 759-9717

Fax

(516) 759-1666

NPI assigned

Aug 14, 2024

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Soundside Physical Therapy PCGroup PAC ID 8527958164, 6 clinicians

New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Soundside Physical Therapy P.C.

  • Physical Therapist
  • Locust Valley, NY
  • NPI 1679679419
  Medicare reassignment Care Compare group NPD
• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1578395166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 BIRCH HILL RD",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115601833",
            "telephone_number": "516-759-9717",
            "fax_number": "516-759-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 BIRCH HILL RD",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115601833",
            "telephone_number": "516-759-9717",
            "fax_number": "516-759-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICCIARDI",
        "first_name": "RALPH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Leask, RD, CDN, MS
• Clara Lee, D.O.
• Jeryl Lehmuller, B.S.E.D
• Karen Christine Leonard, P.T.
• Terrence Robert Leonard, PT
• Michelle Lobo, MD
• Locust Valley Central School District
• Locust Valley Chemists
• Locust Valley Dentistry
• Locust Valley Fire District

• Physical Therapist in Locust Valley, NY
• Providers in Locust Valley, 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 Aug 14, 2024; 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.