Active NPI
Justin Rizzo, D.P.T.
- Physical Therapist
- Centereach, NY
National Provider Identifier
1700122363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 29941
- Practice address
- 141 Mark Tree Rd
Centereach, NY 11720-2221 - Phone
- (631) 467-4235
- Fax
- (631) 467-2655
- NPI assigned
- Dec 28, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 035814 | NY | |
| Physical Therapist | 225100000X | 29941 | MD | Primary |
Addresses
Primary practice location
141 Mark Tree Rd
Centereach, NY 11720-2221
Mailing address
9 Helen St
Centereach, NY 11720-3869
Phone (631) 648-3683
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 |
|---|---|---|---|
| 29941 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716508800000",
"number": "1700122363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 HELEN ST",
"city": "CENTEREACH",
"state": "NY",
"postal_code": "117203869",
"telephone_number": "631-648-3683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 MARK TREE RD",
"city": "CENTEREACH",
"state": "NY",
"postal_code": "117202221",
"telephone_number": "631-467-4235",
"fax_number": "631-467-2655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIZZO",
"first_name": "JUSTIN",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-28",
"last_updated": "2024-05-24",
"certification_date": "2024-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "035814",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "29941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centereach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.