Individual provider Active NPI

Ryan Martin, DPT

  • Physical Therapist
  • Glendale, NY
National Provider Identifier
1780708388
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028643 Issued in NY
Practice address
7119 80TH Street, Ste No 8210
Glendale, NY 11385
Phone
(718) 554-6610
Fax
(718) 360-4908
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 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 028643 NY Primary

Addresses

Primary practice location

7119 80TH Street, Ste No 8210
Glendale, NY 11385

Mailing address

7119 80TH Street, Ste No 8210
Glendale, NY 11385
Phone (718) 554-6610

Other practice location 1

138-28 Queens Blvd.
Store C
Briarwood, NY 11435
Phone (718) 880-2385

Other identifiers 1

IdentifierTypeStateIssuer
02944085MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070428000016 NY Practitioner - Physical Therapist in Private Practice 8325144975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promet Physical Therapy PCGroup PAC ID 6901988849, 7 clinicians

Practice addresses (Care Compare)

7119 80TH St
Suite 8210
Glendale, NY 11385-7733
Phone (718) 554-6610

Merit-based Incentive Payment System (MIPS)

Final score
26.89 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
89.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Promet Physical Therapy, PC Physical Therapist PastSince Feb 27, 2018 Accepting new patients

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1780708388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7119 80TH STREET, STE NO 8210",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "11385",
            "telephone_number": "718-554-6610",
            "fax_number": "718-360-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7119 80TH STREET, STE NO 8210",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "11385",
            "telephone_number": "718-554-6610",
            "fax_number": "718-360-4908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "138-28 QUEENS BLVD.",
            "address_2": "STORE C",
            "address_purpose": "LOCATION",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "11435",
            "country_code": "US",
            "telephone_number": "718-880-2385",
            "fax_number": "718-880-2386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02944085",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.