Organization Active NPI

Lifetime Physical Therapy and Chiropractic Rehabilitation PLLC

  • Physical Therapist
  • Garden City, NY
National Provider Identifier
1821453572
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026960 Issued in NY
Legal business name
LIFETIME PHYSICAL THERAPY AND CHIROPRACTIC REHABILITATION PLLC
Practice address
1000 Zeckendorf Blvd
Garden City, NY 11530-2133
Phone
(516) 513-1510
Fax
(516) 513-1511
NPI assigned
Dec 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Authorized official

Name
Mr. David Ian Lipetz, MSPT, OCS, CERT.MDTNPI 1932151180
Title
Owner
Phone
(516) 513-1510

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 012560 MN
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 026960 NY Primary

Addresses

Primary practice location

1000 Zeckendorf Blvd
Garden City, NY 11530-2133

Mailing address

750 Zeckendorf Blvd
Garden City, NY 11530-2133
Phone (516) 513-1510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160210000469 NY Part B Supplier - Clinic/Group Practice 3971807025 Receives reassigned benefits from 5 practitioners
Practice locations: Garden City, NY

National Provider Directory

National Provider Directory

Locations

750 Zeckendorf Blvd
Garden City, NY 11530
Phone (516) 580-7095

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1821453572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 ZECKENDORF BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302133",
            "telephone_number": "516-513-1510",
            "fax_number": "516-513-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ZECKENDORF BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302133",
            "telephone_number": "516-513-1510",
            "fax_number": "516-513-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME PHYSICAL THERAPY AND CHIROPRACTIC REHABILITATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "LIPETZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-513-1510",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT, OCS, CERT.MDT"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "012560",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.