Individual provider Active NPI

Dominick Demarco, PT, DPT

  • Physical Therapist
  • Stony Brook, NY
National Provider Identifier
1619604055
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2500 Nesconset Hwy BLDG 22B
Stony Brook, NY 11790-2598
Phone
(631) 751-7988
NPI assigned
Aug 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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 Primary

Addresses

Primary practice location

2500 Nesconset Hwy BLDG 22B
Stony Brook, NY 11790-2598

Mailing address

8 Crawford CT
Huntington Station, NY 11746-1502

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230105001354 NY Practitioner - Physical Therapist in Private Practice 1456721596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert Mosca Physical Therapy PLLCGroup PAC ID 5890010979, 4 clinicians

Practice addresses (Care Compare)

2500 Nesconset Hwy
BLDG 22B
Stony Brook, NY 11790-2598
Phone (631) 751-7988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Island Physical Therapy, PC CurrentSince Aug 7, 2022 Accepting new patients
Robert Mosca Physical Therapy, PLLC Physical Therapist CurrentSince Dec 8, 2022 Accepting new patients

Locations

2500 Nesconset Hwy
Bldg 22B
Stony Brook, NY 11790
Phone (631) 751-7988

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": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1619604055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CRAWFORD CT",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 22B",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902598",
            "telephone_number": "631-751-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "DOMINICK",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.