Individual provider Active NPI

Carly Heffron, DPT

  • Physical Therapist
  • White Plains, NY
National Provider Identifier
1750637898
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
035288 Issued in NY
Practice address
4 Westchester Park Dr Ste 315
White Plains, NY 10604-3497
Phone
(914) 688-1770
NPI assigned
Jul 26, 2012
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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 035288 NY Primary

Addresses

Primary practice location

4 Westchester Park Dr Ste 315
White Plains, NY 10604-3497

Mailing address

4 Westchester Park Dr Ste 315
White Plains, NY 10604-3497

Other names 1

  • Carly Jacobson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120822000065 NY Practitioner - Physical Therapist in Private Practice 5193972438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Duke University School of Medicine, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians
Access PT, OT, New York, PLLCGroup PAC ID 3870735897, 9 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

4 Westchester Park Dr
Suite 315
White Plains, NY 10604-3497
Phone (914) 688-1770

444 E Boston Post Rd
Suite 101
Mamaroneck, NY 10543-3704
Phone (914) 510-7005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035288NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Feb 3, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Feb 3, 2025 Accepting new patients
Access PT, OT, New York, PLLC Physical Therapist CurrentSince Jul 29, 2024 Accepting new patients
Premier Physical Therapy and Wellness, PC Physical Therapist PastSince Aug 30, 2012 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

16 Maybrook Rd
Ste L
Campbell Hall, NY 10916

14 Thiells Mount Ivy Rd
Ste 2
Pomona, NY 10970
Phone (845) 694-8808

4 Westchester Park Dr
Ste 315
White Plains, NY 10604
Phone (914) 688-1770

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1750637898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WESTCHESTER PARK DR STE 315",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106043497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WESTCHESTER PARK DR STE 315",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106043497",
            "telephone_number": "914-688-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFRON",
        "first_name": "CARLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "JACOBSON",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.