L.I. Pro Physical Therapy P.C.
NPI 1104164656ActiveOrganization· Physical Therapist· West Islip, NY
Physical Therapist in West Islip, New York, registered in NPPES in January 2013. The authorized official on file is Justin Andrew Minerva, DPT, Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1104164656 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 17, 2013 |
| Last updated in NPPES | Jan 17, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 031214-1 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (NY) |
|---|
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