Individual provider Active NPI

Samantha Dziuba, DPT

  • Physical Therapist
  • Briarcliff Manor, NY
National Provider Identifier
1821332917
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
035697 Issued in NY
Practice address
584 N State Rd
Briarcliff Manor, NY 10510-1522
Phone
(914) 762-2222
Fax
(914) 762-9175
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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 035697 NY Primary

Addresses

Primary practice location

584 N State Rd
Briarcliff Manor, NY 10510-1522

Mailing address

584 N State Rd
Briarcliff Manor, NY 10510-1522
Phone (914) 762-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130408000181 NY Practitioner - Physical Therapist in Private Practice 6608011069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
New York Medical College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

2142 Utopia Pkwy
Whitestone, NY 11357-4142
Phone (718) 767-0610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035697NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Dec 10, 2020 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Dec 10, 2020 Accepting new patients

Locations

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

576 Broadhollow Rd
Melville, NY 11747

79 Ronald Reagan Blvd
Warwick, NY 10990
Phone (845) 328-8967

214 West St
Warwick, NY 10990
Phone (845) 986-5099

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 3

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": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1821332917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 N STATE RD",
            "city": "BRIARCLIFF MANOR",
            "state": "NY",
            "postal_code": "105101522",
            "telephone_number": "914-762-2222",
            "fax_number": "914-762-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 N STATE RD",
            "city": "BRIARCLIFF MANOR",
            "state": "NY",
            "postal_code": "105101522",
            "telephone_number": "914-762-2222",
            "fax_number": "914-762-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIUBA",
        "first_name": "SAMANTHA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Briarcliff Manor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.