Individual provider Active NPI

Gregory John Rahn, P.T.

  • Physical Therapist
  • Kings Park, NY
National Provider Identifier
1992822282
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5555 Issued in NY
Practice address
277 Indian Head Rd
Unit a
Kings Park, NY 11754-4803
Phone
(631) 269-5170
Fax
(631) 269-5283
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5555 NY Primary

Addresses

Primary practice location

277 Indian Head Rd
Unit a
Kings Park, NY 11754-4803

Mailing address

300 Ocean Ave
Northport, NY 11768-1836
Phone (631) 261-6677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000750 NY Practitioner - Physical Therapist in Private Practice 1557380961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

277 Indian Head Rd
Unit a
Kings Park, NY 11754-4810
Phone (631) 269-5170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5555NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Park Physical Therapy PC Physical Therapist CurrentSince Nov 17, 1988 Accepting new patients

Locations

277 Indian Head Rd
Unit A
Kings Park, NY 11754
Phone (631) 269-5170

277 Indian Head Rd
Kings Park, NY 11754
Phone (631) 269-5170

Organizations & group practices 1

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1992822282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OCEAN AVE",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681836",
            "telephone_number": "631-261-6677",
            "fax_number": "631-261-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 INDIAN HEAD RD",
            "address_2": "UNIT A",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117544803",
            "telephone_number": "631-269-5170",
            "fax_number": "631-269-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHN",
        "first_name": "GREGORY",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "5555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.