Individual provider Active NPI

Henrique Dossantos

  • Physical Therapist
  • Huntington, NY
National Provider Identifier
1730116393
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
020147 Issued in NY
Practice address
1206 E Jericho Tpke
Huntington, NY 11743-5453
Phone
(631) 549-1550
Fax
(631) 549-1562
NPI assigned
Jun 27, 2006
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 020147 NY Primary

Addresses

Primary practice location

1206 E Jericho Tpke
Huntington, NY 11743-5453

Mailing address

1206 E Jericho Tpke
Huntington, NY 11743-5453

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060504000462 NY Practitioner - Physical Therapist in Private Practice 1355351396 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

1206 E Jericho Tpke
Unit a
Huntington, NY 11743-5453
Phone (631) 549-1550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020147NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dix Hills Physical Therapy, PC Physical Therapist CurrentSince Dec 1, 2011 Accepting new patients
John Titcomb, D.C,P.C. PastSince Dec 1, 2011 Accepting new patients

Locations

1206 E Jericho Tpke
Unit A
Huntington, NY 11743
Phone (631) 549-0749

Organizations & group practices 2

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730116393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 E JERICHO TPKE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117435453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 E JERICHO TPKE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117435453",
            "telephone_number": "631-549-1550",
            "fax_number": "631-549-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSSANTOS",
        "first_name": "HENRIQUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, 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.