NPIMap

Organization Active NPI

Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

Doing business as Sports Therapy And Rehabilitation Services

  • Hand Physical Therapist
  • Great Neck, NY
National Provider Identifier
1942653563
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Physical TherapistTaxonomy code 2251H1200X
Legal business name
SPORTS PHYSICAL THERAPY OCCUPATIONAL THERAPY AND REHABILITATION SERVIC
Doing business as
Sports Therapy And Rehabilitation Services
Practice address
833 Northern Blvd Ste 235
Great Neck, NY 11021-5339
Phone
(516) 288-3400
NPI assigned
Jul 19, 2016
Last updated
Dec 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Authorized official

Name
Daniel Vaknin, PT
Title
Vice President
Phone
(516) 321-7801

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251H1200X Primary
Hand Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225XH1200X

Addresses

Primary practice location

833 Northern Blvd Ste 235
Great Neck, NY 11021-5339

Mailing address

3 Huntington Quadrangle Ste 103N
Melville, NY 11747-4601
Phone (516) 474-2816

Other names 1

  • Sports Therapy And Rehabilitation Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160217002440 NY DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 0446140446 1 other NPI on this enrollment
Practice locations: Great Neck, NY

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sports Physical Therapy Occupationa Therapy and Rehabilitation Servic26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1942653563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HUNTINGTON QUADRANGLE STE 103N",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474601",
            "telephone_number": "516-474-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 NORTHERN BLVD STE 235",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215339",
            "telephone_number": "516-288-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS PHYSICAL THERAPY OCCUPATIONAL THERAPY AND REHABILITATION SERVIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "VAKNIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "516-321-7801",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251H1200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Hand",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Therapy And Rehabilitation Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sports Therapy And Rehabilitation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.