Organization Active NPI

Advanced Sports Physical Therapy, PC

  • Physical Therapy Clinic/Center
  • East Setauket, NY
National Provider Identifier
1952513384
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
014530-1 Issued in NY
Legal business name
ADVANCED SPORTS PHYSICAL THERAPY, PC
Practice address
100 N Belle Mead Rd
Suite a
East Setauket, NY 11733-3455
Phone
(631) 689-5940
NPI assigned
May 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Authorized official

Name
Frank McCoy, PHYSICAL THERAPISTNPI 1306827993
Title
Owner
Phone
(631) 689-5940

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 Therapy Clinic/Center 261QP2000X 014530-1 NY Primary

Addresses

Primary practice location

100 N Belle Mead Rd
Suite a
East Setauket, NY 11733-3455

Mailing address

100 N Belle Mead Rd
Suite a
East Setauket, NY 11733-3455
Phone (631) 689-5940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040730000036 NY Part B Supplier - Clinic/Group Practice 1153391750 Receives reassigned benefits from 4 practitioners
Practice locations: East Setauket, NY

National Provider Directory

National Provider Directory

Locations

100 N Belle Mead Ave
Ste A
East Setauket, NY 11733
Phone (631) 689-5940

275 Route 25A
Unit 43
Miller Place, NY 11764
Phone (631) 474-2700

275 Route 25A
Unit 45
Miller Place, NY 11764
Phone (631) 364-8114

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1952513384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BELLE MEAD RD",
            "address_2": "SUITE A",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333455",
            "telephone_number": "631-689-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BELLE MEAD RD",
            "address_2": "SUITE A",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333455",
            "telephone_number": "631-689-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPORTS PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-06",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-689-5940",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "014530-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.