Timothy Stauder, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045159 Issued in NY

Practice address

1169 Wantagh Ave
Wantagh, NY 11793-2136

Phone

(516) 785-4800

Fax

(516) 785-4800

NPI assigned

Jun 10, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Physical Therapy, Occupational Therapy and Speech Language PAGroup PAC ID 7012997638, 385 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path

  • Physical Therapist
  • Harrison, NY
  • NPI 1396799409
  Medicare reassignment Care Compare group NPD
• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1215637699
  NPD

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1972162386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932136",
            "telephone_number": "516-785-4800",
            "fax_number": "516-785-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUDER",
        "first_name": "TIMOTHY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Allen Spiro, DDS
• Dorothy Stack, PT
• Maritza Tarancon Stan, RPH
• Christina Joan Stanco, LMHC, M.A.
• Lauren Stansfield
• Terry Stefanou
• Cassandra Stefko
• David Lesher Stein, LCSW
• Mark Stein, M.D.
• Samantha Marie Stein, LMSW

• Physical Therapist in Wantagh, NY
• Providers in Wantagh, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.