Individual provider Active NPI

Demetrios Vasilios Mesimeris, PT, DPT, CSCS

  • Orthopedic Physical Therapist
  • Oakdale, NY
National Provider Identifier
1750115192
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
053060 Issued in NY
Practice address
1242 Montauk Hwy
Oakdale, NY 11769-1435
Phone
(631) 626-6578
NPI assigned
Aug 28, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 053060 NY Primary

Addresses

Primary practice location

1242 Montauk Hwy
Oakdale, NY 11769-1435

Mailing address

1242 Montauk Hwy
Oakdale, NY 11769-1435
Phone (631) 626-6578

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
053060NYMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Amato PT PLLC Orthopedic CurrentSince Dec 18, 2024 Accepting new patients
Endgame Physical Therapy Orthopedic PastSince Sep 1, 2024 Accepting new patients

Locations

1242 Montauk Hwy
Oakdale, NY 11769
Phone (631) 626-6578

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1750115192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1242 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691435",
            "telephone_number": "631-626-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1242 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691435",
            "telephone_number": "631-626-6578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESIMERIS",
        "first_name": "DEMETRIOS",
        "middle_name": "VASILIOS",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "053060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.