Individual provider Active NPI

Smaro Mirra, PT

  • Pediatric Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1801164868
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
025606-1 Issued in NY
Practice address
1 Prospect Park SW
Apt 3a
Brooklyn, NY 11215-5961
Phone
(917) 747-1496
Fax
(347) 599-1973
NPI assigned
Dec 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 025606-1 NY Primary

Addresses

Primary practice location

1 Prospect Park SW
Apt 3a
Brooklyn, NY 11215-5961

Mailing address

1 Prospect Park SW
Apt 3a
Brooklyn, NY 11215-5961
Phone (917) 747-1496

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210903001115 NY Practitioner - Physical Therapist in Private Practice 2264838952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Northern Blvd
Suite 150
Great Neck, NY 11021-5325
Phone (516) 466-9730

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

State licenses

LicenseStateTypeSpecialty
025606-1NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Pediatrics CurrentSince Aug 31, 2021 Accepting new patients

Locations

800 E Gate Blvd
Garden City, NY 11530

1000 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 466-4700

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

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": "1323129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1801164868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PROSPECT PARK SW",
            "address_2": "APT 3A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155961",
            "telephone_number": "917-747-1496",
            "fax_number": "347-599-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PROSPECT PARK SW",
            "address_2": "APT 3A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155961",
            "telephone_number": "917-747-1496",
            "fax_number": "347-599-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRRA",
        "first_name": "SMARO",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-06",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "025606-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.