Individual provider Active NPI

Melissa Sander

  • Physical Therapist
  • Manorville, NY
National Provider Identifier
1790990174
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028576-1 Issued in NY
Practice address
5 Tee View CT
Manorville, NY 11949-2939
Phone
(631) 874-3032
Fax
(631) 874-4105
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 028576-1 NY Primary

Addresses

Primary practice location

5 Tee View CT
Manorville, NY 11949-2939

Mailing address

42 Brookhaven Dr
Sound Beach, NY 11789-1213

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070725000615 NY Practitioner - Physical Therapist in Private Practice 0840391579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Virginia Commonwealth University, School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
We Care Physical Therapy, P.C.Group PAC ID 4587554688, 5 clinicians

Practice addresses (Care Compare)

5 Tee View CT
Manorville, NY 11949-2939
Phone (631) 874-0962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028576-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
We Care Physical Therapy, P.C. Physical Therapist CurrentSince Jun 1, 2007 Accepting new patients

Organizations & group practices 1

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790990174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 BROOKHAVEN DR",
            "city": "SOUND BEACH",
            "state": "NY",
            "postal_code": "117891213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TEE VIEW CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492939",
            "telephone_number": "631-874-3032",
            "fax_number": "631-874-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDER",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028576-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manorville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.