Gregory Bret Neilsen, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22606 Issued in NY

Practice address

500 Portion Rd
Suite 5
Lake Ronkonkoma, NY 11779

Phone

(631) 588-2100

Fax

(631) 588-2299

NPI assigned

Aug 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

May accept Medicare assignment

Group practices

GNLC Physical Therapy PLLCGroup PAC ID 5890002307, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• GNLC Physical Therapy PLLC

  • Physical Therapist
  • Lake Ronkonkoma, NY
  • NPI 1376930974
  Medicare reassignment Care Compare group
• Brian V. Becker M.a.P.T.PLLC

  dba Excel Rehabilitation and Sports Therapy

  • Physical Therapist
  • Babylon, NY
  • NPI 1295824027
  Medicare reassignment NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851301311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PORTION RD",
            "address_2": "SUITE 5",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "11779",
            "telephone_number": "631-588-2100",
            "fax_number": "631-588-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PORTION RD",
            "address_2": "SUITE 5",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "11779",
            "telephone_number": "631-588-2100",
            "fax_number": "631-588-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILSEN",
        "first_name": "GREGORY",
        "middle_name": "BRET",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "22606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Motisi
• Marlon Joseph Murasko, MD
• Hannah Nadraus
• Jennin Mary Nangle
• Grace Marie Napolitano
• Bettina S. Niederer, MD
• Patricia M. Nolan, MD
• Christina Noonan, DPT
• North Shore Hematology Oncology Associates PC (Ny Cancer & Blood Specialists)
• North Shore Medical Group of Mt Sinai School of Medicine (North Shore Medical Group)

• Physical Therapist in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, NY by specialty
• Physical Therapist in New York

• 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.