Active NPI
Michael Magistro, ATC
- Athletic Trainer
- Port Jefferson Station, NY
National Provider Identifier
1740551480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 67002001
- Practice address
- 125 Terryville Rd
Apt 8C
Port Jefferson Station, NY 11776-1300 - Phone
- (631) 974-2883
- NPI assigned
- Jan 25, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 67002001 | NY | Primary |
Addresses
Primary practice location
125 Terryville Rd
Apt 8C
Port Jefferson Station, NY 11776-1300
Mailing address
125 Terryville Rd
Apt 8C
Port Jefferson Station, NY 11776-1300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1026686 | Other | NY | NATIONAL ATHLETIC TRAINER ASSOCIATION |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67002001 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327449600000",
"number": "1740551480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 TERRYVILLE RD",
"address_2": "APT 8C",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117761300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 TERRYVILLE RD",
"address_2": "APT 8C",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117761300",
"telephone_number": "631-974-2883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGISTRO",
"first_name": "MICHAEL",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-25",
"last_updated": "2012-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "67002001",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL ATHLETIC TRAINER ASSOCIATION",
"identifier": "1026686",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.