Individual provider Active NPI

Nadir Memon, D.P.T.

  • Physical Therapist
  • East Northport, NY
National Provider Identifier
1629389259
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032749-1 Issued in NY
Practice address
346 Larkfield Rd
East Northport, NY 11731-2905
Phone
(631) 623-6371
Fax
(631) 623-6373
NPI assigned
Jun 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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 032749-1 NY Primary

Addresses

Primary practice location

346 Larkfield Rd
East Northport, NY 11731-2905

Mailing address

346 Larkfield Rd
East Northport, NY 11731-2905
Phone (631) 623-6371

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902000483 NY Practitioner - Physical Therapist in Private Practice 4880718402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1551 Islip Ave
Central Islip, NY 11722-3501
Phone (631) 761-9521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
032749NYMDPharmacist
032749-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Accelerated Rehabilitation and Physical Therapy PC Physical Therapist CurrentSince Dec 1, 2012 Accepting new patients

Locations

1551 Islip Ave
Central Islip, NY 11722
Phone (631) 761-9521

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1629389259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312905",
            "telephone_number": "631-623-6371",
            "fax_number": "631-623-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312905",
            "telephone_number": "631-623-6371",
            "fax_number": "631-623-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMON",
        "first_name": "NADIR",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032749-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; 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.