Individual provider Active NPI

Jed Matthew Ragotero Ong

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1609331941
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
043358 Issued in NY
Practice address
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone
(516) 829-0030
Fax
(516) 829-0030
NPI assigned
Jan 31, 2019
Last updated
Jan 31, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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 043358 NY Primary

Addresses

Primary practice location

475 Northern Blvd Ste 11
Great Neck, NY 11021-4802

Mailing address

475 Northern Blvd Ste 27
Great Neck, NY 11021-4802
Phone (516) 829-0030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190221002801 NY Practitioner - Physical Therapist in Private Practice 0749529550 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

9614 Metropolitan Ave
Suite 1550
Forest Hills, NY 11375-6674
Phone (781) 424-9531

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043358NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Sep 16, 2022 Accepting new patients
Physical Therapy Services of Flatiron PC Physical Therapist CurrentSince Feb 6, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Sep 16, 2022 Accepting new patients
Reddy Care Physical Therapy PC Physical Therapist CurrentSince Jun 1, 2022 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

309 Northwest Dr
Farmingdale, NY 11735
Phone (516) 420-2900

27278 Grand Central Pkwy
Floral Park, NY 11005
Phone (516) 344-0030

9614 Metropolitan Ave
Ste 1550
Forest Hills, NY 11375
Phone (781) 424-9531

475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023

475 Northern Blvd
Ste 27
Great Neck, NY 11021

138 5th Ave
Fl 2
New York, NY 10011
Phone (212) 287-4257

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1609331941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 27",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 11",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-829-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONG",
        "first_name": "JED",
        "middle_name": "MATTHEW RAGOTERO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.