Individual provider Active NPI

Michael Scott Rosenhouse, PHYSICAL THERAPIST

  • Physical Therapist
  • Deer Park, NY
National Provider Identifier
1588871222
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4142-1 Issued in NY
Practice address
2103 Deer Park Ave
Deer Park, NY 11729-1317
Phone
(631) 242-4500
Fax
(631) 242-0885
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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 4142-1 NY Primary

Addresses

Primary practice location

2103 Deer Park Ave
Deer Park, NY 11729-1317

Mailing address

2103 Deer Park Ave
Deer Park, NY 11729-1317
Phone (631) 242-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120124000662 NY Practitioner - Physical Therapist in Private Practice 4688841141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1974
Medicare assignment
May accept Medicare assignment
Group practices
Syosset Physical Therapy and Athletic Training PLLCGroup PAC ID 7113282005, 10 clinicians

Practice addresses (Care Compare)

2103 Deer Park Ave
Deer Park, NY 11729-1317
Phone (516) 622-9797

Merit-based Incentive Payment System (MIPS)

Final score
93.75 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4142-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Syosset Physical Therapy and Athletic Training PLLC Physical Therapist CurrentSince Dec 20, 2023 Accepting new patients
Bienetre Medical PC Physical Therapist Past Accepting new patients

Locations

2103 Deer Park Ave
Deer Park, NY 11729
Phone (631) 242-4500

115 Eileen Way
Syosset, NY 11791
Phone (516) 622-9797

Organizations & group practices 2

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1588871222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291317",
            "telephone_number": "631-242-4500",
            "fax_number": "312-420-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291317",
            "telephone_number": "631-242-4500",
            "fax_number": "631-242-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENHOUSE",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "4142-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.