LONG ISLAND CHIROPRACTIC & PHYSICAL THERAPY, PLLC
NPI 1417207028
Chiropractor in Smithtown, NY
About Long Island Chiropractic & Physical Therapy, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LONG ISLAND CHIROPRACTIC & PHYSICAL THERAPY, PLLC (NPI 1417207028) is a healthcare organization registered as a chiropractor in Smithtown, New York and active in the NPI registry since September 2012. The organization lists Donald John Wallace, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Long Island Chiropractic & Physical Therapy, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Long Island Chiropractic & Physical Therapy, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (6)
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 Long Island Chiropractic & Physical Therapy, PLLC's NPI number?
The NPI number for Long Island Chiropractic & Physical Therapy, PLLC is 1417207028. It was assigned to this organization in the NPPES registry on September 12, 2012.
Where is Long Island Chiropractic & Physical Therapy, PLLC located?
Long Island Chiropractic & Physical Therapy, PLLC is located at 20 Gilbert Ave Suite 201, Smithtown, NY 11787. The listed phone number is (631) 724-1991.
What is Long Island Chiropractic & Physical Therapy, PLLC's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Long Island Chiropractic & Physical Therapy, PLLC enrolled in Medicare?
Yes. Long Island Chiropractic & Physical Therapy, PLLC is registered in the Medicare PECOS enrollment system.
When is Long Island Chiropractic & Physical Therapy, PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Long Island Chiropractic & Physical Therapy, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Long Island Chiropractic & Physical Therapy, PLLC. 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. The largest specialties are Chiropractic (3), Physical Therapist in Private Practice (2) and Nurse Practitioner (1). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Long Island Chiropractic & Physical Therapy, PLLC was last updated on November 19, 2012. 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.
# Long Island Chiropractic & Physical Therapy, Pllc · NPI 1417207028
Chiropractor organization in Smithtown, New York. Organization record, active in the CMS NPPES registry since September 12, 2012.
## Identity
- **NPI:** 1417207028 (Entity type: Organization)
- **Enumerated:** September 12, 2012
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Donald Wallace, PRESIDENT
## Practice location
- **Address:** 20 GILBERT AVE, SUITE 201, Smithtown, NY 11787
- **Phone:** (631) 724-1991 · **Fax:** (631) 724-1995
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 6 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Chiropractic (3), Physical Therapist in Private Practice (2), Nurse Practitioner (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 19, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1417207028) · Data from the CMS NPPES public registry.