NPIMap

Organization Active NPI

Professional Occupational & Physical Therapy, PLLC

  • Physical Therapist
  • Oceanside, NY
National Provider Identifier
1629763909
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
Practice address
2837 Long Beach Rd
Oceanside, NY 11572-2233
Phone
(516) 461-6919
Fax
(516) 461-6918
NPI assigned
Apr 11, 2023
Last updated
Apr 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Kathleen Brush
Title
Manager of Credentialing
Phone
(631) 359-5859

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

2837 Long Beach Rd
Oceanside, NY 11572-2233

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002

National Provider Directory

National Provider Directory
Tax ID family
Prof Occptnl Phyl Thpy119 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2837 Long Beach Rd
Oceanside, NY 11572
Phone (516) 461-6919

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1629763909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2837 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115722233",
            "telephone_number": "516-461-6919",
            "fax_number": "516-461-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "MANAGER OF CREDENTIALING",
        "authorized_official_telephone_number": "631-359-5859"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.