Individual provider Active NPI

Demetrios Farmakopoulos, MSPT OCS

  • Physical Therapist
  • Valhalla, NY
National Provider Identifier
1871556498
Registry record updated Feb 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0166051 Issued in NY
Practice address
465 Columbus Ave
Valhalla, NY 10595-1336
Phone
(914) 741-2850
Fax
(914) 741-2851
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 016605-1 NY
Physical Therapist 225100000X 0166051 NY Primary

Addresses

Primary practice location

465 Columbus Ave
Valhalla, NY 10595-1336

Mailing address

465 Columbus Ave
Valhalla, NY 10595-1336
Phone (914) 741-2850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040803000027 NY Practitioner - Physical Therapist in Private Practice 7810968021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

465 Columbus Ave
Valhalla, NY 10595-1336
Phone (914) 741-2850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0166051NYMDPhysical Therapist
016605-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Physical Therapy & Sports Rehabilitation, PLLC CurrentSince Jun 1, 2004 Accepting new patients

Locations

465 Columbus Ave
Ste 130
Valhalla, NY 10595
Phone (914) 741-2850

465 Columbus Ave
Valhalla, NY 10595
Phone (914) 401-8082

Organizations & group practices 1

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1871556498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 COLUMBUS AVE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951336",
            "telephone_number": "914-741-2850",
            "fax_number": "914-741-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 COLUMBUS AVE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951336",
            "telephone_number": "914-741-2850",
            "fax_number": "914-741-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMAKOPOULOS",
        "first_name": "DEMETRIOS",
        "name_prefix": "Mr.",
        "credential": "MSPT OCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016605-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0166051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2024; 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.