Michael Scottodimaso and Tara Derosa, PT, OT, PLLC
NPI 1154575074 · Physical Therapist · Babylon, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Michael Scottodimaso and Tara Derosa, PT, OT, PLLC is a Physical Therapist organization in Babylon, NY (NPI 1154575074).
Provider details
- NPI number
- 1154575074
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Michael Scottodimaso, Owner(631) 669-0333
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Occupational Therapist225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- Cbc Ctr for Sports & Physical Therapy
Additional practice locations (2)
- 111 Grand AveMassapequa, NY 11758-4905Phone: (631) 669-0333Fax: (631) 669-2436
- 5500 Merrick RdMassapequa, NY 11758-6231Phone: (631) 669-0333Fax: (631) 669-2436
Registry dates
- Enumerated
- 2008-11-05
- Last updated
- 2026-03-20
- Certified
- 2026-03-20
Frequently asked questions
- What is Michael Scottodimaso and Tara Derosa, PT, OT, PLLC's NPI number?
- Michael Scottodimaso and Tara Derosa, PT, OT, PLLC's National Provider Identifier (NPI) is 1154575074, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Michael Scottodimaso and Tara Derosa, PT, OT, PLLC?
- Michael Scottodimaso and Tara Derosa, PT, OT, PLLC is classified in the NPPES registry as Physical Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Michael Scottodimaso and Tara Derosa, PT, OT, PLLC located?
- Michael Scottodimaso and Tara Derosa, PT, OT, PLLC's practice location on file with NPPES is 51 John St Ste 3, Babylon, NY 11702-2928.
- What is Michael Scottodimaso and Tara Derosa, PT, OT, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Michael Scottodimaso and Tara Derosa, PT, OT, PLLC is (631) 669-0333.
- Does Michael Scottodimaso and Tara Derosa, PT, OT, PLLC accept Medicare?
- Michael Scottodimaso and Tara Derosa, PT, OT, PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Michael Scottodimaso and Tara Derosa, PT, OT, PLLC?
- The authorized official listed on Michael Scottodimaso and Tara Derosa, PT, OT, PLLC's NPPES record is Michael Scottodimaso, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Michael Scottodimaso and Tara Derosa, PT, OT, PLLC's NPI active?
- Yes — Michael Scottodimaso and Tara Derosa, PT, OT, PLLC's NPI (1154575074) is active in the NPPES registry as of the last update on 2026-03-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.