NPIMap

Organization Active NPI

Professional Care Physical Therapy and Rehabilitation P.C

  • Physical Therapist
  • East Patchogue, NY
National Provider Identifier
1659518157
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
025766 Issued in NY
Legal business name
PROFESSIONAL CARE PHYSICAL THERAPY AND REHABILITATION P.C
Practice address
191 Patchogue Yaphank Rd
East Patchogue, NY 11772-4899
Phone
(631) 775-0971
Fax
(631) 475-0975
NPI assigned
Jan 21, 2009
Last updated
Nov 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Authorized official

Name
George Ciresi III, D.P.T.NPI 1366484651
Title
Owner
Phone
(631) 775-0971

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 025766 NY Primary

Addresses

Primary practice location

191 Patchogue Yaphank Rd
East Patchogue, NY 11772-4899

Mailing address

191 Patchogue Yaphank Rd
East Patchogue, NY 11772-4899
Phone (631) 775-0971

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090304000028 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7517023351 Receives reassigned benefits from 28 practitioners
Practice locations: East Patchogue, NY; Riverhead, NY; Islip, NY

National Provider Directory

National Provider Directory
Tax ID family
Professional Care Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

285 Sills Rd
Bldg 10
East Patchogue, NY 11772
Phone (631) 447-6600

285 Sills Rd
Bldg 10D
East Patchogue, NY 11772
Phone (631) 438-0777

518 E Main St
Riverhead, NY 11901
Phone (631) 287-1663

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1659518157",
    "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": "191 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724899",
            "telephone_number": "631-775-0971",
            "fax_number": "631-475-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL CARE PHYSICAL THERAPY AND REHABILITATION P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "CIRESI",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-775-0971",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.