Russell J Poker, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

013149 Issued in NY

Practice address

475 Northern Blvd Ste 11
Great Neck, NY 11021-4802

Phone

(516) 829-0030

Fax

(516) 466-7723

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

State University of New York at Stony Brook, School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reddy Care Physical Therapy PCGroup PAC ID 5890685986, 139 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 and National Provider Directory roles.

• Reddy Care Physical Therapy PC

  • Specialist
  • Great Neck, NY
  • NPI 1932171097

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Reddy Care Physical and Occupational Therapy PLLC

  • Specialist
  • Great Neck, NY
  • NPI 1477052967

  Physical Therapist

  NPD
• East Bay Chiropractic Wellnes PC

  • Chiropractor
  • Bellmore, NY
  • NPI 1174015127
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1669544797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2473 MERRICK RD",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105705",
            "telephone_number": "516-804-9078",
            "fax_number": "516-804-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 11",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2473 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Bellmore",
            "state": "NY",
            "postal_code": "117105705",
            "country_code": "US",
            "telephone_number": "516-804-9078",
            "fax_number": "516-804-9081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POKER",
        "first_name": "RUSSELL",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC BS",
            "identifier": "Q29Q71",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01751959",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Anthony Pizzarelli
• Jordan Placella, DPT
• Michael Alan Pliskin, D.P.M.
• Barbara Podwall, MD
• Narges Poinda
• Glenn L Pollack, PSY.D
• Stacey Polynice
• Janet Pomerantz, M.D.
• Anthony Lik Hang Poon, DPT
• David Yao Fei Poon, M.D.

• Physical Therapist in Great Neck, NY
• Providers in Great Neck, 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 Oct 24, 2018; 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.