Ryan Kroeger, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

014689-01 Issued in NY

Practice address

760 Montauk Hwy
Water Mill, NY 11976-2600

Phone

(631) 812-5566

NPI assigned

Mar 31, 2025

Last updated

Mar 31, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path

  • Physical Therapist
  • Harrison, NY
  • NPI 1396799409
  NPD
• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1215637699
  NPD (past)

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

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1871396291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 MONTAUK HWY",
            "city": "WATER MILL",
            "state": "NY",
            "postal_code": "119762600",
            "telephone_number": "631-812-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 MONTAUK HWY",
            "city": "WATER MILL",
            "state": "NY",
            "postal_code": "119762600",
            "telephone_number": "631-812-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROEGER",
        "first_name": "RYAN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "014689-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Elizabeth Gambino, BA
• Gertrud Elisabeth Hoertnagl-Pereira, OTR/L
• David C Hou, DDS, MS
• Aneta Kaczmarski, DPT
• Caleigh Marie Kiembock, PT, DPT
• Charlotte Laguardia, MS, CNS
• Richard M. Lawless, TH.D.
• Anthony Lombardo, R.N.
• Robert S Macbarb, DC
• Joanne Mercer, D.P.M.

• Physical Therapy Assistant in Water Mill, NY
• Providers in Water Mill, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.