Individual provider Active NPI

Rachel Elizabeth Lys, P.T.

  • Physical Therapist
  • Montauk, NY
National Provider Identifier
1578621959
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027731 Issued in NY
Practice address
240 Edgemere St
Room 203
Montauk, NY 11954
Phone
(631) 668-1372
NPI assigned
Dec 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 027731 NY Primary

Addresses

Primary practice location

240 Edgemere St
Room 203
Montauk, NY 11954

Mailing address

12 Cedar Ridge Dr
East Hampton, NY 11937-1704
Phone (631) 324-1432

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110602000409 NY Practitioner - Physical Therapist in Private Practice 9133299985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 S Elmwood Ave
Montauk, NY 11954-5421
Phone (631) 668-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027331NYMDClinical Psychologist
027731NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Hampton Physical Therapy PLLC Physical Therapist CurrentSince Dec 1, 2012 Accepting new patients

Locations

6 S Elmwood Ave
Montauk, NY 11954
Phone (631) 668-7600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578621959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CEDAR RIDGE DR",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119371704",
            "telephone_number": "631-324-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 EDGEMERE ST",
            "address_2": "ROOM 203",
            "city": "MONTAUK",
            "state": "NY",
            "postal_code": "11954",
            "telephone_number": "631-668-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYS",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montauk, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.