NPIMap

Organization Active NPI

Prosports Physical Therapy PC

  • Physical Medicine & Rehabilitation Physician
  • Huntington, NY
National Provider Identifier
1902928138
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
7489 Issued in NY
Legal business name
PROSPORTS PHYSICAL THERAPY PC
Practice address
467 New York Ave
Huntington, NY 11743-3441
Phone
(631) 424-1100
Fax
(631) 424-1105
NPI assigned
Apr 6, 2007
Last updated
Aug 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Authorized official

Name
Michael Lacasse, P.T.NPI 1487020426
Title
Owner
Phone
(631) 424-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 7489 NY Primary

Addresses

Primary practice location

467 New York Ave
Huntington, NY 11743-3441

Mailing address

467 New York Ave
Huntington, NY 11743-3441
Phone (631) 424-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090430000492 NY Part B Supplier - Clinic/Group Practice 9739071481 Receives reassigned benefits from 12 practitioners
Practice locations: Huntington, NY; Locust Valley, NY; Oyster Bay, NY

National Provider Directory

National Provider Directory

Locations

467 New York Ave
Unit 1
Huntington, NY 11743

11 Birch Hill Rd
Locust Valley, NY 11560
Phone (516) 801-6020

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1902928138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 NEW YORK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433441",
            "telephone_number": "631-424-1100",
            "fax_number": "631-424-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 NEW YORK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433441",
            "telephone_number": "631-424-1100",
            "fax_number": "631-424-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPORTS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "LACASSE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-424-1100",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "7489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.