NPIMap

Organization Active NPI

Rom on the Run Physical Therapy, PC

  • Physical Therapist
  • East Northport, NY
National Provider Identifier
1740455633
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
012591-1 Issued in NY
Legal business name
ROM ON THE RUN PHYSICAL THERAPY, PC
Practice address
290 Larkfield Rd Unit B
East Northport, NY 11731-2444
Phone
(631) 547-5500
Fax
(631) 427-2223
NPI assigned
Apr 23, 2008
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
David W Fischer, PTNPI 1912914623
Title
Owner/President
Phone
(631) 547-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 012591-1 NY
Physical Therapist 225100000X 012591-1 NY Primary

Addresses

Primary practice location

290 Larkfield Rd Unit B
East Northport, NY 11731-2444

Mailing address

290 Larkfield Rd Unit B
East Northport, NY 11731-2444
Phone (631) 547-5500

Other practice location 1

175 E Main St
Suite 110
Huntington, NY 11743-2939
Phone (631) 427-7600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080527000756 NY Part B Supplier - Clinic/Group Practice 6709955180 Receives reassigned benefits from 3 practitioners
Practice locations: East Northport, NY

National Provider Directory

National Provider Directory

Locations

290 Larkfield Rd
Unit B
East Northport, NY 11731
Phone (631) 547-5500

175 E Main St
Ste 110
Huntington, NY 11743
Phone (631) 427-7600

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1740455633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 LARKFIELD RD UNIT B",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312444",
            "telephone_number": "631-547-5500",
            "fax_number": "631-427-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 LARKFIELD RD UNIT B",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312444",
            "telephone_number": "631-547-5500",
            "fax_number": "631-427-2223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 E Main St",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "NY",
            "postal_code": "117432939",
            "country_code": "US",
            "telephone_number": "631-427-7600",
            "fax_number": "631-427-7636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROM ON THE RUN PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "631-547-5500",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "012591-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012591-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.