Individual provider Active NPI

Megan Baird Illari, P.T.

  • Physical Therapist
  • Saint James, NY
National Provider Identifier
1932320462
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
018220-1 Issued in NY
Practice address
51 Cleremont Ave
Saint James, NY 11780
Phone
(631) 686-6377
NPI assigned
May 1, 2007
Last updated
Apr 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 018220-1 NY Primary

Addresses

Primary practice location

51 Cleremont Ave
Saint James, NY 11780

Mailing address

51 Cleremont Ave
Saint James, NY 11780
Phone (631) 686-6377

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120516000003 NY Practitioner - Physical Therapist in Private Practice 3779746540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illari Physcial Therapy P.CGroup PAC ID 0446538474, 2 clinicians

Practice addresses (Care Compare)

2314 N Ocean Ave
Farmingville, NY 11738-2915
Phone (631) 438-0400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018220NYMDPsychologist
018220-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Illari Physcial Therapy P.C. CurrentSince Jul 1, 2016 Accepting new patients

Locations

2314 N Ocean Ave
Farmingville, NY 11738
Phone (631) 438-0400

269 E Main St
Bldg F
Smithtown, NY 11787
Phone (516) 316-2032

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1932320462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CLEREMONT AVE",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "11780",
            "telephone_number": "631-686-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 CLEREMONT AVE",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "11780",
            "telephone_number": "631-686-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLARI",
        "first_name": "MEGAN",
        "middle_name": "BAIRD",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018220-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint James, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.