Active NPI
Jack Christopher Standwill
- Physical Therapist
- Amityville, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 055505
- Practice address
- 805 Broadway
Amityville, NY 11701-2260 - Phone
- (631) 608-8874
- NPI assigned
- Oct 29, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 055505 | NY | Primary |
Addresses
Primary practice location
805 Broadway
Amityville, NY 11701-2260
Mailing address
12 Skipper Dr
West Islip, NY 11795-5030
Phone (631) 873-6442
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300
805 Broadway
Suite 100
Amityville, NY 11701-2260
Phone (631) 608-8874
9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055505 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC | Physical Therapist | Current | Accepting new patients |
Locations
805 Broadway
Ste 100
Amityville, NY 11701
Phone (631) 608-8874
800 E Gate Blvd
Garden City, NY 11530
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 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.
-
- Occupational Therapist
- Garden City, NY
- NPI 1356742365
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1801764832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 SKIPPER DR",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117955030",
"telephone_number": "631-873-6442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 BROADWAY",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117012260",
"telephone_number": "631-608-8874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANDWILL",
"first_name": "JACK",
"middle_name": "CHRISTOPHER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-10-29",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "055505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Amityville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.