Individual provider Active NPI

Robert Klare, PT, CHT

  • Physical Therapist
  • Port Jefferson, NY
National Provider Identifier
1790765675
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027058 Issued in NY
Practice address
70 N Country Rd
Suite 103
Port Jefferson, NY 11777-2161
Phone
(631) 331-3608
Fax
(631) 331-2392
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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 027058 NY Primary

Addresses

Primary practice location

70 N Country Rd
Suite 103
Port Jefferson, NY 11777-2161

Mailing address

70 N Country Rd
Suite 103
Port Jefferson, NY 11777-2161
Phone (631) 331-3608

Other identifiers 2

IdentifierTypeStateIssuer
7236714OtherNYAETNA
Q32K0OtherNYEMPIRE BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070720000768 NY Practitioner - Physical Therapist in Private Practice 0345341392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Boston University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

1733 N Ocean Ave
Suite a
Medford, NY 11763-2606
Phone (631) 207-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients

Locations

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

90 Northern Blvd
Greenvale, NY 11548
Phone (516) 626-5080

1733 N Ocean Ave
Ste A
Medford, NY 11763
Phone (631) 207-3600

576 Broadhollow Rd
Melville, NY 11747

16 E 52nd St
Fl 6
New York, NY 10022
Phone (212) 752-2400

5380 Nesconset Hwy
Port Jefferson Station, NY 11776
Phone (631) 474-4096

70 N Country Rd
Ste 103
Prt Jefferson, NY 11777
Phone (631) 331-3608

33 Flying Point Rd
Ste 250
Southampton, NY 11968
Phone (631) 268-2901

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 3

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1790765675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 N COUNTRY RD",
            "address_2": "SUITE 103",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772161",
            "telephone_number": "631-331-3608",
            "fax_number": "631-331-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 N COUNTRY RD",
            "address_2": "SUITE 103",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772161",
            "telephone_number": "631-331-3608",
            "fax_number": "631-331-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLARE",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PT, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7236714",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS",
            "identifier": "Q32K0",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.