Individual provider Active NPI

Somsak Vanichpong

  • Physical Therapist
  • West Nyack, NY
National Provider Identifier
1699813196
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
020186 Issued in NY
Practice address
2 Crosfield Ave
West Nyack, NY 10994-2226
Phone
(845) 358-8989
Fax
(845) 358-8985
NPI assigned
Feb 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 020186 NY Primary

Addresses

Primary practice location

2 Crosfield Ave
West Nyack, NY 10994-2226

Mailing address

2 Crosfield Ave
West Nyack, NY 10994-2226
Phone (845) 358-8989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080227000524 NY Practitioner - Physical Therapist in Private Practice 2961586003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ospre PT, PCGroup PAC ID 5991974024, 2 clinicians

Practice addresses (Care Compare)

30 Burda Ave
New City, NY 10956-1418
Phone (845) 634-1625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020186NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportscare Physical Therapy of Ny, P.C. Physical Therapist CurrentSince Aug 22, 2007 Accepting new patients
Ospre PT, PC Physical Therapist CurrentSince Aug 8, 2008 Accepting new patients
Rockland Orthopedics and Sports Medicine PC Past Accepting new patients
Flowing Physical Therapy PLLC Physical Therapist Past Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist Past Accepting new patients

Locations

410 Airport Executive Park
Nanuet, NY 10954
Phone (845) 356-2020

2 Perlman Dr
Spring Valley, NY 10977
Phone (845) 371-2032

2 Crosfield Ave
West Nyack, NY 10994
Phone (212) 725-8511

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699813196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CROSFIELD AVE",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942226",
            "telephone_number": "845-358-8989",
            "fax_number": "845-358-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CROSFIELD AVE",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942226",
            "telephone_number": "845-358-8989",
            "fax_number": "845-358-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANICHPONG",
        "first_name": "SOMSAK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.