Individual provider Active NPI

Babu Samuel Moses, PT,DSC,ECS,MTC

  • Physical Therapist
  • Freeport, NY
National Provider Identifier
1962442681
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
009705 Issued in NY
Practice address
49 Church St
Freeport, NY 11520-3830
Phone
(516) 623-6253
Fax
(516) 623-8450
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7161 NY
Physical Therapist 225100000X 009705 NY Primary

Addresses

Primary practice location

49 Church St
Freeport, NY 11520-3830

Mailing address

579 Garfield Rd
North Baldwin, NY 11510-1003
Phone (516) 223-2201

Other identifiers 1

IdentifierTypeStateIssuer
02088379MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050415000222 NY Practitioner - Physical Therapist in Private Practice 7113824541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Body Power Physical Therapy, PCGroup PAC ID 6901067552, 2 clinicians

Practice addresses (Care Compare)

49 Church St
Freeport, NY 11520-3837
Phone (516) 623-6253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7161NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Homeside Rehab, PT, OT, SLP LLC Physical Therapist CurrentSince Feb 25, 2019 Accepting new patients
Body Power Physical Therapy, P C Physical Therapist PastSince Aug 21, 2002 Accepting new patients

Locations

441 Route 306
Ste 2
Monsey, NY 10952
Phone (201) 952-4436

296 Route 59
Ste 1225
Suffern, NY 10901

Organizations & group practices 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1962442681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 GARFIELD RD",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115101003",
            "telephone_number": "516-223-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 CHURCH ST",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203830",
            "telephone_number": "516-623-6253",
            "fax_number": "516-623-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "BABU",
        "middle_name": "SAMUEL",
        "name_prefix": "Mr.",
        "credential": "PT,DSC,ECS,MTC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "7161",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "009705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02088379",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.