NPIMap

Organization Active NPI

In House Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Staten Island, NY
National Provider Identifier
1003118829
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
17990 Issued in NY
Legal business name
IN HOUSE PHYSICAL THERAPY PLLC
Practice address
112 Bidwell Ave
Staten Island, NY 10314-3177
Phone
(718) 637-4603
Fax
(718) 448-8287
NPI assigned
Nov 30, 2010
Last updated
Aug 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tory Badalamenti, PTNPI 1295870079
Title
Owner
Phone
(718) 637-4603

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 17990 NY Primary

Addresses

Primary practice location

112 Bidwell Ave
Staten Island, NY 10314-3177

Mailing address

112 Bidwell Ave
Staten Island, NY 10314-3177
Phone (718) 637-4603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110314000227 NY Part B Supplier - Clinic/Group Practice 3971785890 Receives reassigned benefits from 18 practitioners
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502150400000",
    "number": "1003118829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BIDWELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143177",
            "telephone_number": "718-637-4603",
            "fax_number": "718-448-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BIDWELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143177",
            "telephone_number": "718-637-4603",
            "fax_number": "718-448-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOUSE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2017-08-08",
        "status": "A",
        "authorized_official_last_name": "BADALAMENTI",
        "authorized_official_first_name": "TORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-637-4603",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "17990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.