Individual provider Active NPI

Dennis Patrick Sall, DPT, DC

  • Physical Therapist
  • Holbrook, NY
National Provider Identifier
1891708301
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032930-1 Issued in NY
Practice address
900 Main St
Ste 101
Holbrook, NY 11741-1623
Phone
(631) 476-4600
Fax
(631) 476-8236
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X0098411 NY
Physical Therapist 225100000X 032930-1 NY Primary

Addresses

Primary practice location

900 Main St
Ste 101
Holbrook, NY 11741-1623

Mailing address

900 Main St
Ste 101
Holbrook, NY 11741-1623
Phone (631) 476-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100430000025 NY Practitioner - Chiropractic 5193852754 Reassigns benefits to 1 organization
I20101209001075 NY Practitioner - Physical Therapist in Private Practice 5193852754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
New York Chiropractic College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

900 Main St
Suite 101
Holbrook, NY 11741-1623
Phone (631) 476-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X0098411NYMDChiropractor
032930-1NYMDPhysical Therapist
009841NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Sall Chiropractic, P.C. Chiropractor CurrentSince Sep 7, 2000 Accepting new patients

Locations

1970 Route 112
Ste 6
Coram, NY 11727
Phone (631) 451-1515

900 Main St
Ste 101
Holbrook, NY 11741
Phone (631) 476-4600

Organizations & group practices 2

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1891708301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "address_2": "STE 101",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411623",
            "telephone_number": "631-476-4600",
            "fax_number": "631-476-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "address_2": "STE 101",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411623",
            "telephone_number": "631-476-4600",
            "fax_number": "631-476-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALL",
        "first_name": "DENNIS",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DPT, DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0098411",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032930-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; 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.