L.I. PRO PHYSICAL THERAPY P.C.
NPI 1104164656
Physical Therapist in West Islip, NY

Active since January 17, 2013
11 CANBY CT, WEST ISLIP, NY 11795(631) 873-6100 Get Directions Write a Review

NPPES record last updated: January 17, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About L.i. Pro Physical Therapy P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

L.I. PRO PHYSICAL THERAPY P.C. (NPI 1104164656) is a healthcare organization registered as a physical therapist in West Islip, New York and active in the NPI registry since January 2013. The organization lists Justin Andrew Minerva, Owner, as its authorized official.

NPPES Registry Identity

NPI1104164656
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameL.I. PRO PHYSICAL THERAPY P.C.
Location Address11 CANBY CTWest Islip, NY 11795-2309
Mailing Address11 Canby CtWest Islip, NY 11795-2309 · (631) 873-6100
Organization SubpartNo
Authorized OfficialJustin Andrew MinervaOwner · (631) 873-6100
Enumeration DateJanuary 17, 2013
✔ NPI 1104164656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in NY · 031214-1
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
11 CANBY CT, West Islip, NY 11795

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

L.i. Pro Physical Therapy P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to L.I. Pro Physical Therapy P.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

Physical Therapist in Private Practice
NPI 1124324942
11 CANBY CT
West Islip, NY 11795
(631) 482-8870
✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is L.I. Pro Physical Therapy P.C.'s NPI number?

The NPI number for L.I. Pro Physical Therapy P.C. is 1104164656. It was assigned to this organization in the NPPES registry on January 17, 2013.

Where is L.I. Pro Physical Therapy P.C. located?

L.I. Pro Physical Therapy P.C. is located at 11 Canby Ct, West Islip, NY 11795. The listed phone number is (631) 873-6100.

What is L.I. Pro Physical Therapy P.C.'s specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is L.I. Pro Physical Therapy P.C. enrolled in Medicare?

Yes. L.I. Pro Physical Therapy P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through L.I. Pro Physical Therapy P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to L.I. Pro Physical Therapy P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for L.I. Pro Physical Therapy P.C. was last updated on January 17, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.