Individual provider Active NPI

Raymond Hanson, PT

  • Physical Therapist
  • Commack, NY
National Provider Identifier
1841377272
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010088 Issued in NY
Practice address
159 Indian Head Rd
Commack, NY 11725-2205
Phone
(631) 543-4500
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 010088 NY Primary

Addresses

Primary practice location

159 Indian Head Rd
Commack, NY 11725-2205

Mailing address

30 Oceanview Blvd
Manorville, NY 11949-2956
Phone (631) 325-0993

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100226000394 NY Practitioner - Physical Therapist in Private Practice 4486799699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

159 Carleton Ave
Central Islip, NY 11722-4172
Phone (631) 650-2510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010088NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Select Healthcare, Inc. CurrentSince Sep 21, 2016 Accepting new patients
United Cerebral Palsy Association of Greater Suffolk, Inc. Past Accepting new patients

Locations

159 Carleton Ave
Central Islip, NY 11722
Phone (631) 439-4300

250 Marcus Blvd
Hauppauge, NY 11788
Phone (631) 439-4300

883 E Main St
Riverhead, NY 11901
Phone (631) 284-5500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCJFAD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841377272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 OCEANVIEW BLVD",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492956",
            "telephone_number": "631-325-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 INDIAN HEAD RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252205",
            "telephone_number": "631-543-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "RAYMOND",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.