JWG Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5249 Issued in NY

Legal business name

JWG PHYSICAL THERAPY PC

Practice address

1 School St
Suite 105a
Glen Cove, NY 11542-2545

Phone

(516) 656-4824

Fax

(516) 656-4833

NPI assigned

Jul 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. John William Gardiner, P.T.

Title

Executive Director

Phone

(516) 656-4824

Specialties & licenses 1

Addresses

Other identifiers 12

Other names 1

• Gardiner Physical Therapy Services Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sheetal Desai, DPT

  • Physical Therapist
  • Glen Cove, NY
  • NPI 1871521781
  NPD (past)
• Jancyrus Raymundo Pangan, D.P.T.

  • Physical Therapist
  • Glen Cove, NY
  • NPI 1437484003
  NPD (past)

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1871783779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SCHOOL ST",
            "address_2": "SUITE 105A",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422545",
            "telephone_number": "516-656-4824",
            "fax_number": "516-656-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SCHOOL ST",
            "address_2": "SUITE 105A",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422545",
            "telephone_number": "516-656-4824",
            "fax_number": "516-656-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JWG PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "GARDINER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "516-656-4824",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "5249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA PROVIDER NUMBER",
            "identifier": "136840",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO PROVIDER NUMBER",
            "identifier": "2904019",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP PROVIDER NUMBER",
            "identifier": "58958P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER NUMBER",
            "identifier": "P2720801",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE-MEDICAI",
            "identifier": "100206834602",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0026201",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "600934000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1199 PROVIDER NUMBER",
            "identifier": "273729",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET PROVIDER NUMBER",
            "identifier": "5C7048",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PROVIDER NUMBER",
            "identifier": "6605247",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO PROVIDER NUMBER",
            "identifier": "7004397",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE PROVIDER NUMBER",
            "identifier": "QN6301",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gardiner Physical Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gardiner Physical Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• April A Jones, MD
• Megan M Jones, M.A.
• Viviana Beatriz Jorquera, RN
• Joseph I. Lopez, M.D., P.C.
• Nisha John Joseph, PHARMD
• Krystle Kalimnios
• Sarwat Kamal, MD
• Stefanie P Kane, LMSW CDCES
• Wallie Kanishka, PHYSICIAN ASSISTANT
• Kanors Senior Center, Inc.

• Physical Therapist in Glen Cove, NY
• Providers in Glen Cove, 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 Jun 21, 2018; 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.