Sportscare Physical Therapy, PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

010663-1 Issued in NY

Legal business name

SPORTSCARE PHYSICAL THERAPY, PC

Practice address

814 Fulton St
Suite B
Farmingdale, NY 11735-3638

Phone

(516) 420-1927

Fax

(516) 420-1952

NPI assigned

Aug 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John G Fox, P.T.NPI 1457358509

Title

Owner

Phone

(516) 420-1927

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John G Fox, P.T.

  • Physical Therapist
  • Farmingdale, NY
  • NPI 1457358509
  Medicare reassignment Care Compare group NPD Authorized official
• Kayla Christine Hatki, PT, DPT

  • Physical Therapist
  • Farmingdale, NY
  • NPI 1053053264
  Medicare reassignment Care Compare group NPD
• Jonathan Gary Pavlica, DPT

  • Physical Therapist
  • Oyster Bay, NY
  • NPI 1780054817
  Medicare reassignment Care Compare group NPD
• Erica Lynn Martello, PT, DPT

  • Physical Therapist
  • New Hyde Park, NY
  • NPI 1588067235
  NPD

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700895646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 FULTON ST",
            "address_2": "SUITE B",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353638",
            "telephone_number": "516-420-1927",
            "fax_number": "516-420-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 FULTON ST",
            "address_2": "SUITE B",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353638",
            "telephone_number": "516-420-1927",
            "fax_number": "516-420-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTSCARE PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-420-1927",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010663-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6601383",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2C7574",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "41830",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "180617P",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southampton Hospital
• Linda Diane Southard, MSED,BCABA
• Kelley Okeefe Spada, LMHC
• Kristen Alexis Spataro, M.A. CCC-SLP
• Michelle Shanta Spencer, LMHC
• Sophy St. Germain
• Rebecca Ann Stalek, MD
• Christiane Stallone
• Gordana Staniszewski
• State of New York

• Physical Therapist in Farmingdale, NY
• Providers in Farmingdale, 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 22, 2020; 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.