Stephen I. Zimmerman, PH.D., P.T., P.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

003994-1 Issued in NY

Legal business name

STEPHEN I. ZIMMERMAN, PH.D., P.T., P.C.

Practice address

2421 Grand Ave
Baldwin, NY 11510-3219

Phone

(516) 377-7964

Fax

(516) 377-7760

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephen I. Zimmerman, P.T., D.P.T., PH.D.

Title

President

Phone

(516) 377-7964

Specialties & licenses 1

Addresses

Other identifiers 10

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1811048549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 GRAND AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103219",
            "telephone_number": "516-377-7964",
            "fax_number": "516-377-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 GRAND AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103219",
            "telephone_number": "516-377-7964",
            "fax_number": "516-377-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN I. ZIMMERMAN, PH.D., P.T., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-377-7964",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.T., D.P.T., PH.D."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "003994-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00336567",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA PROVIDER #",
            "identifier": "46295",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET PROVIDER #",
            "identifier": "5C7329",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP PROVIDER #",
            "identifier": "145529P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY PROVIDER #",
            "identifier": "AZ00575",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER #",
            "identifier": "0731899",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROV. #",
            "identifier": "259759",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ORTHONET PROVIDER #",
            "identifier": "5120L",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PROVIDER #",
            "identifier": "6698763",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS BLUE SH",
            "identifier": "QM8451",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.