Active NPI
Scott Portnoy
- Physical Rehabilitation Occupational Therapist
- Medford, NY
National Provider Identifier
1972320901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- 17109
- Practice address
- 90 Pacific Dunes CT
Medford, NY 11763-2405 - Phone
- (310) 666-2465
- NPI assigned
- Sep 23, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 17109 | NC | Primary |
Addresses
Primary practice location
90 Pacific Dunes CT
Medford, NY 11763-2405
Mailing address
90 Pacific Dunes CT
Medford, NY 11763-2405
Phone (310) 666-2465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17109 | NC | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1972320901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 PACIFIC DUNES CT",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117632405",
"telephone_number": "310-666-2465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 PACIFIC DUNES CT",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117632405",
"telephone_number": "310-666-2465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTNOY",
"first_name": "SCOTT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-23",
"last_updated": "2024-09-23",
"certification_date": "2024-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "NC",
"license": "17109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.