Shanna Haddow, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

050850 Issued in NY

Practice address

159 Islip Ave
Islip, NY 11751-3210

Phone

(631) 650-6347

Fax

(631) 650-6346

NPI assigned

Aug 21, 2023

Last updated

Aug 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Care Physical Therapy and Rehabilitation P.CGroup PAC ID 7517023351, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Professional Care Physical Therapy and Rehabilitation P.C

  • Physical Therapist
  • East Patchogue, NY
  • NPI 1659518157
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1659155810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724899",
            "telephone_number": "631-775-0971",
            "fax_number": "631-475-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 ISLIP AVE",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513210",
            "telephone_number": "631-650-6347",
            "fax_number": "631-650-6346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 Patchogue Yaphank Rd",
            "address_purpose": "LOCATION",
            "city": "East Patchogue",
            "state": "NY",
            "postal_code": "117724899",
            "country_code": "US",
            "telephone_number": "631-775-0971",
            "fax_number": "631-475-0975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HADDOW",
        "first_name": "SHANNA",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Joseph Greico, PT,MS,OCS,DPT
• Lisa Ann Griffiths
• Rachel Gruler, BCBA LP-LBA
• Mark Gudesblatt, M.D.
• Geeta Gupta, M.D
• Tyesha Hall, LMSW
• Susan E Hammond, L.M.T.
• Cathy A Hanna-Talbot, NNP
• Eileen Marie Hannon, NP
• Rebecca Mary Harras, MSN, CNS

• Physical Therapist in Islip, NY
• Providers in Islip, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.