Individual provider Active NPI

Jonathan Gary Pavlica, DPT

  • Physical Therapist
  • Oyster Bay, NY
National Provider Identifier
1780054817
Registry record updated Oct 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039152 Issued in NY
Practice address
123 South St Ste 110
Oyster Bay, NY 11771-2274
Phone
(516) 624-6739
NPI assigned
Oct 1, 2015
Last updated
Oct 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2015

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 039152 NY Primary

Addresses

Primary practice location

123 South St Ste 110
Oyster Bay, NY 11771-2274

Mailing address

7 Bowden LN
Glen Head, NY 11545-2201
Phone (516) 457-5773

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151214000490 NY Practitioner - Physical Therapist in Private Practice 8325349541 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians
Sportscare Physical Therapy, PCGroup PAC ID 8022163492, 3 clinicians

Practice addresses (Care Compare)

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

800 E Gate Blvd
Garden City, NY 11530-2105
Phone (516) 745-8070

814 Fulton St
Suite B
Farmingdale, NY 11735-3638
Phone (516) 420-1927

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Merit-based Incentive Payment System (MIPS)

Final score
77.35 of 100Reported as group
Quality
73.31
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportscare Physical Therapy, PC Physical Therapist CurrentSince Mar 10, 2025 Accepting new patients
Frank Anthony Cesare Physical Therapist PastSince Feb 18, 2019 Accepting new patients

Locations

814 Fulton St
Ste B
Farmingdale, NY 11735
Phone (516) 420-1927

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": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1780054817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BOWDEN LN",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115452201",
            "telephone_number": "516-457-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SOUTH ST STE 110",
            "city": "OYSTER BAY",
            "state": "NY",
            "postal_code": "117712274",
            "telephone_number": "516-624-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLICA",
        "first_name": "JONATHAN",
        "middle_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oyster Bay, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.