Individual provider Active NPI

Amy Rose, P.T.

  • Physical Therapist
  • North Babylon, NY
National Provider Identifier
1710071253
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010250-1 Issued in NY
Practice address
710 Deer Park Ave
North Babylon, NY 11703-4307
Phone
(631) 587-0946
Fax
(631) 587-0979
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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 010250-1 NY Primary

Addresses

Primary practice location

710 Deer Park Ave
North Babylon, NY 11703-4307

Mailing address

710 Deer Park Ave
North Babylon, NY 11703-4307
Phone (631) 587-0946

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080630000000 NY Practitioner - Physical Therapist in Private Practice 6507938065 Reassigns benefits to 1 organization
Practice locations: North Babylon, NY

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Columbia University College of Physicians and Surgeons, 1988
Medicare assignment
May accept Medicare assignment
Group practices
Amy Rose Physical Therapy PCGroup PAC ID 6709256936, 2 clinicians

Practice addresses (Care Compare)

710 Deer Park Ave
Babylon, NY 11703-4307
Phone (631) 587-0946

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010250-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Rose Physical Therapy, PC Physical Therapist CurrentSince Sep 16, 2022 Accepting new patients

Locations

661 Deer Park Ave
Ste 2
Babylon, NY 11702
Phone (631) 587-0946

710 Deer Park Ave
North Babylon, NY 11703
Phone (631) 321-1100

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1710071253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117034307",
            "telephone_number": "631-587-0946",
            "fax_number": "631-587-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117034307",
            "telephone_number": "631-587-0946",
            "fax_number": "631-587-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "AMY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010250-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.