Active NPI
Gladys F Materon, PT
- Physical Therapist
- Hicksville, NY
National Provider Identifier
1649488842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 014794
- Practice address
- 100 Newbridge Rd
8
Hicksville, NY 11801-3963 - Phone
- (516) 822-9400
- Fax
- (516) 822-3418
- NPI assigned
- May 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 014794 | NY | Primary |
Addresses
Primary practice location
100 Newbridge Rd
8
Hicksville, NY 11801-3963
Mailing address
56 Wyckoff St
Hicksville, NY 11801-2836
Phone (516) 932-0363
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014794 | Other | NY | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014794 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Newbridge Physical Therapy PC | Physical Therapist | Past | Accepting new patients |
| GFM Rehab Physical Therapy P.C. | Past | Accepting new patients | |
| Tender Touch Physical Therapy PC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Home Health Agency
- Hicksville, NY
- NPI 1912346644
-
- Physical Therapist
- Hicksville, NY
- NPI 1366650566
-
- Orthopedic Physical Therapist
- Jamaica, NY
- NPI 1790993996
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1649488842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 WYCKOFF ST",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118012836",
"telephone_number": "516-932-0363",
"fax_number": "513-822-3418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 NEWBRIDGE RD",
"address_2": "8",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118013963",
"telephone_number": "516-822-9400",
"fax_number": "516-822-3418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATERON",
"first_name": "GLADYS",
"middle_name": "F",
"name_prefix": "Prof.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "014794",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "014794",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hicksville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.