Individual provider Active NPI

Sierra Schrader, PT, DPT

  • Physical Therapist
  • Bay Shore, NY
National Provider Identifier
1790381812
Registry record updated Dec 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
046743 Issued in NY
Practice address
30A Mowbray Ave
Bay Shore, NY 11706-8813
Phone
(508) 505-1519
NPI assigned
Dec 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2020

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 046743 NY Primary

Addresses

Primary practice location

30A Mowbray Ave
Bay Shore, NY 11706-8813

Mailing address

30A Mowbray Ave
Bay Shore, NY 11706-8813
Phone (508) 505-1519

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210128000436 NY Practitioner - Physical Therapist in Private Practice 4183038490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goodman Physical Therapy PCGroup PAC ID 1355573155, 4 clinicians

Practice addresses (Care Compare)

255 Higbie LN
West Islip, NY 11795-2825
Phone (631) 661-3180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Goodman Physical Therapy PC Physical Therapist CurrentSince Sep 17, 2022 Accepting new patients
Island Musculoskeletal Care, M.D., P.C. Physical Therapist CurrentSince Jan 4, 2021 Accepting new patients
Island Musculoskeletal Care MD PC Physical Therapist Current Accepting new patients
Island Musculoskeletal Care MD PC Physical Therapist CurrentSince Jan 4, 2021 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist Past Accepting new patients

Locations

400 W Main St
Ste 340
Babylon, NY 11702
Phone (631) 403-4719

1993 Deer Park Ave
Deer Park, NY 11729
Phone (631) 242-4031

255 Higbie Ln
West Islip, NY 11795
Phone (631) 661-3180

Networks

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

Organizations & group practices 5

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": "1607212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607212800000",
    "number": "1790381812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30A MOWBRAY AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068813",
            "telephone_number": "508-505-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30A MOWBRAY AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068813",
            "telephone_number": "508-505-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRADER",
        "first_name": "SIERRA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-06",
        "last_updated": "2020-12-06",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2020; 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.