NPIMap

Organization Active NPI

Island Physical Therapy of Riverhead

  • Physical Therapy Clinic/Center
  • Riverhead, NY
National Provider Identifier
1770622854
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ISLAND PHYSICAL THERAPY OF RIVERHEAD
Practice address
185 Old Country Rd
Suite 4
Riverhead, NY 11901
Phone
(631) 208-4443
Fax
(631) 208-4448
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Dr. Vincent J Barry, PT DPTNPI 1982790549
Title
Co Owner President
Phone
(631) 208-4443

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

185 Old Country Rd
Suite 4
Riverhead, NY 11901

Mailing address

185 Old Country Rd
Suite 4
Riverhead, NY 11901
Phone (631) 208-4443

Other identifiers 7

IdentifierTypeStateIssuer
Q07B0OtherEMPIRE CATHERINE BARRY
801067OtherEMPIRE GOVT J SCALAMANDRE
QL8661OtherEMPIRE JOHN SCALAMANDRE
126269OtherVYTRA VINCENT BARRY
QM5151OtherEMPIRE VINCENT BARRY
801062OtherEMPIRE GOVT C BARRY
818365OtherEMPIRE GOVT V BARRY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315001567 NY Part B Supplier - Clinic/Group Practice 7113817107 Receives reassigned benefits from 5 practitioners
Practice locations: Riverhead, NY

National Provider Directory

National Provider Directory

Locations

110 South St
Greenport, NY 11944
Phone (631) 477-3717

185 Old Country Rd
Ste 4
Riverhead, NY 11901
Phone (631) 208-4443

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1770622854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 OLD COUNTRY RD",
            "address_2": "SUITE 4",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "11901",
            "telephone_number": "631-208-4443",
            "fax_number": "631-208-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 OLD COUNTRY RD",
            "address_2": "SUITE 4",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "11901",
            "telephone_number": "631-208-4443",
            "fax_number": "631-208-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND PHYSICAL THERAPY OF RIVERHEAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CO OWNER PRESIDENT",
        "authorized_official_telephone_number": "631-208-4443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE CATHERINE BARRY",
            "identifier": "Q07B0",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE GOVT J SCALAMANDRE",
            "identifier": "801067",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE JOHN SCALAMANDRE",
            "identifier": "QL8661",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA VINCENT BARRY",
            "identifier": "126269",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE VINCENT BARRY",
            "identifier": "QM5151",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE GOVT C BARRY",
            "identifier": "801062",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE GOVT V BARRY",
            "identifier": "818365",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.