Sylvene T Blissett, PT
Individual provider Active NPI Physical Therapist · Freeport, NY
NPI 1821207341 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1821207341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10594 (NY)
- Practice address
- 515 Nassau Ave
Freeport, NY 11520-6320 - Phone
- (516) 378-6122
- Fax
- (516) 771-0067
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- The Shield of David, Inc.
Practice addresses (Care Compare)
14461 Roosevelt Ave
Flushing, NY 11354-6252
Phone 71893987001311
3909 214TH PL
Bayside, NY 11361-2123
Phone 71822957572289
The Shield Institute
Flushing, NY 11354-6252
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160517001876 | NY | Practitioner - Physical Therapist in Private Practice | 3375832215 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004360 | NY | MD | Physical Therapist |
| 10594 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Shield of David, Inc. | Current |
Accepting new patients |
Locations
3909 214th Pl
Flushing, NY 11361
Phone (718) 229-5757
14461 Roosevelt Ave
Flushing, NY 11354
Phone (718) 886-1534
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10594 | NY | Yes |
Addresses
Primary practice location
515 Nassau Ave
Freeport, NY 11520-6320
Mailing address
515 Nassau Ave
Freeport, NY 11520-6320
Phone (516) 378-6122
Other providers in Freeport, NY
- Jeniece Best
- Corey Ian Bickoff
- Bilingual Evaluator a.Bakalarz
- Molly Bishop
- BJ'S Wholesale Club Inc.
- Ellen Sue Blume
- Renee Denise Bodley
- Body Power Physical Therapy PC
- Body Power Physical Therapy, P C
- Body Power Physical Therapy,P.C.
All providers in Freeport, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.