Proactive Physical Therapy P.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

020539 Issued in NY

Legal business name

PROACTIVE PHYSICAL THERAPY P.C.

Practice address

339 Route 202 BLDG 2
Somers, NY 10589-3253

Phone

(914) 617-8211

NPI assigned

Jan 31, 2008

Last updated

Oct 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William Cameron Minnich, M.S., P.T.NPI 1588610141

Title

President

Phone

(914) 617-8211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Tax ID family

Proactive Physical Therapy PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Proactive Physical Therapy, PC

  • Physical Therapist
  • Mahopac, NY
  • NPI 1972623981
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Cameron Minnich, P.T.

  • Physical Therapist
  • Somers, NY
  • NPI 1588610141
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1881871911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 ROUTE 202 BLDG 2",
            "city": "SOMERS",
            "state": "NY",
            "postal_code": "105893253",
            "telephone_number": "914-617-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 ROUTE 202 BLDG 2",
            "city": "SOMERS",
            "state": "NY",
            "postal_code": "105893253",
            "telephone_number": "914-617-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "MINNICH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CAMERON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-617-8211",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S., P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorraine Jill Parker, D.C.
• Steven Paulus
• PDG Psychological
• L Scott Pisciotti, DC
• Robert Louis Pitaro, M.D.
• Emilie Jean Procario, MS, RDN, CDN
• Leslie Prusnofsky, MD
• Donna S Prywes, LCSW
• Harry Charles Prywes, DPM
• Psychological and Communication Therapies, PLLC

• Physical Therapist in Somers, NY
• Providers in Somers, 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 Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.