Individual provider Active NPI

Michael John Deprimo, P.T.

  • Physical Therapist
  • East Meadow, NY
National Provider Identifier
1871549923
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
016321-1 Issued in NY
Practice address
1530 Front St
East Meadow, NY 11554-2265
Phone
(516) 520-3053
Fax
(516) 520-5715
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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 016321-1 NY Primary

Addresses

Primary practice location

1530 Front St
East Meadow, NY 11554-2265

Mailing address

1530 Front St
East Meadow, NY 11554-2265
Phone (516) 520-3053

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdeprimo221952@nyumc.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060418000633 NY Practitioner - Physical Therapist in Private Practice 4587673678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1530 Front St
East Meadow, NY 11554-2265
Phone (516) 324-7500

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016321-1NYMDPhysical Therapist
016321NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Winthrop Community Medical Affiliates PC Past Accepting new patients

Locations

1530 Front St
East Meadow, NY 11554
Phone (516) 324-7500

975 Stewart Ave
Garden City, NY 11530
Phone (516) 222-8600

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

Interoperability endpoints

  • Direct secure messaging: mdeprimo221952@nyumc.direct-ci.com

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1871549923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 FRONT ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542265",
            "telephone_number": "516-520-3053",
            "fax_number": "516-520-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 FRONT ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542265",
            "telephone_number": "516-520-3053",
            "fax_number": "516-520-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPRIMO",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016321-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdeprimo221952@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "1530 Front St",
            "city": "East Meadow",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115542265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.