Form Physical Therapy Lifestyle Wellness PLLC
NPI 1629903760ActiveOrganization· Physical Therapist· Bayside, NY
Physical Therapist in Bayside, New York, registered in NPPES in June 2026. The authorized official on file is Dan Thomas, Practice Administrator.
Overview
| NPI | 1629903760 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 17, 2026 |
| Last updated in NPPES | Jun 17, 2026 |
| Certified by provider | Jun 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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