NPIMap

Organization Active NPI

William Joseph Vanvynck Physical Therapy, P.C.

  • Physical Therapist
  • Huntington, NY
National Provider Identifier
1972963874
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028860 Issued in NY
Legal business name
WILLIAM JOSEPH VANVYNCK PHYSICAL THERAPY, P.C.
Doing business as
PARK AVENUE PHYSICAL THERAPY
Practice address
175 E Main St
Suite 110
Huntington, NY 11743-2939
Phone
(631) 427-7600
Fax
(631) 427-7636
NPI assigned
Mar 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Authorized official

Name
Mr. William Joseph Vanvynck, P.T.NPI 1770641169
Title
Owner
Phone
(516) 637-0791

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 028860 NY Primary

Addresses

Primary practice location

175 E Main St
Suite 110
Huntington, NY 11743-2939

Mailing address

175 E Main St
Suite 110
Huntington, NY 11743-2939
Phone (631) 427-7600

Other names 1

  • PARK AVENUE PHYSICAL THERAPY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160407000497 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0042518045 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Salonga, NY; Huntington, NY

National Provider Directory

National Provider Directory

Locations

10 Fort Salonga Rd
Ste 2A
Northport, NY 11768
Phone (631) 320-1100

Practitioners & affiliated clinicians

Practitioners 3

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": "1457049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1972963874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E MAIN ST",
            "address_2": "SUITE 110",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432939",
            "telephone_number": "631-427-7600",
            "fax_number": "631-427-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E MAIN ST",
            "address_2": "SUITE 110",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432939",
            "telephone_number": "631-427-7600",
            "fax_number": "631-427-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM JOSEPH VANVYNCK PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "VANVYNCK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-637-0791",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARK AVENUE PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.