Individual provider Active NPI

Apoorva Vishwanath Bangera

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1972133759
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047728 Issued in NY
Practice address
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone
(516) 829-0030
NPI assigned
Jan 22, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193400000X SINGLE SPECIALTY GROUP 2255A2300X
Physical Therapist 225100000X 047728 NY Primary

Addresses

Primary practice location

475 Northern Blvd Ste 11
Great Neck, NY 11021-4802

Mailing address

31 N Millpage Dr
Bethpage, NY 11714-4820
Phone (617) 952-1921

Other practice location 1

31 N Millpage Dr
Bethpage, NY 11714-4820
Phone (617) 952-1921

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220510002533 NY Practitioner - Physical Therapist in Private Practice 6901283084 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

801 Merrick Ave
East Meadow, NY 11554-4748
Phone (516) 393-8900

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047728NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Single Specialty CurrentSince Oct 1, 2024 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Oct 1, 2024 Accepting new patients
Reddy Care Physical Therapy PC Single Specialty CurrentSince Aug 24, 2022 Accepting new patients
Theradynamics Rehab. PT, OT & SLP, PLLC Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients

Locations

20832 Cross Island Pkwy
Ste 32
Bayside, NY 11360
Phone (516) 466-7723

1811 Hone Ave
Bronx, NY 10461
Phone (516) 499-9016

280 W 231st St
Bronx, NY 10463
Phone (718) 548-1212

2024 Deer Park Ave
Deer Park, NY 11729
Phone (516) 243-0247

801 Merrick Ave
East Meadow, NY 11554
Phone (516) 393-8900

309 Northwest Dr
Farmingdale, NY 11735
Phone (516) 420-2900

27278 Grand Central Pkwy
Floral Park, NY 11005
Phone (516) 344-0030

475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023

18716 Hillside Ave
Jamaica, NY 11432
Phone (718) 206-1288

2421 Long Beach Rd
Oceanside, NY 11572
Phone (516) 766-1717

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

972 Brush Hollow Rd
Westbury, NY 11590

150 Woodbury Rd
Woodbury, NY 11797
Phone (516) 367-1111

Organizations & group practices 4

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": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1972133759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 N MILLPAGE DR",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117144820",
            "telephone_number": "617-952-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 11",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 N Millpage Dr",
            "address_purpose": "LOCATION",
            "city": "Bethpage",
            "state": "NY",
            "postal_code": "117144820",
            "country_code": "US",
            "telephone_number": "617-952-1921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANGERA",
        "first_name": "APOORVA",
        "middle_name": "VISHWANATH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 24, 2022; 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.