Individual provider Active NPI

Amr H Mostafa

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1003369505
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039402-1 Issued in NY
Practice address
353 Ocean Ave
Apt Prof1
Brooklyn, NY 11226-1326
Phone
(718) 940-2100
NPI assigned
Aug 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 039402-1 NY Primary

Addresses

Primary practice location

353 Ocean Ave
Apt Prof1
Brooklyn, NY 11226-1326

Mailing address

3702 Shore Pkwy
2ND Floor
Brooklyn, NY 11235-1717
Phone (347) 666-7816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200728001150 NY Practitioner - Physical Therapist in Private Practice 2668896382 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039402-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Luna Care Physical Therapy PLLC Physical Therapist CurrentSince Jan 5, 2023 Accepting new patients
Atlantic Endocrinology and Diabetes PC Physical Therapist CurrentSince Nov 8, 2023 Accepting new patients
Ahm Physical Therapy PC Physical Therapist CurrentSince Jun 1, 2020 Accepting new patients

Locations

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

9725 63rd Dr
Rego Park, NY 11374
Phone (718) 271-8185

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1003369505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 SHORE PKWY",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112351717",
            "telephone_number": "347-666-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 OCEAN AVE",
            "address_2": "APT PROF1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112261326",
            "telephone_number": "718-940-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSTAFA",
        "first_name": "AMR",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-01",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039402-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.