Organization Active NPI

Ultra Health PT & Pta, PLLC

Doing business as Ultra Health Physical & Aquatic Therapy

  • Physical Therapist
  • Bay Shore, NY
National Provider Identifier
1013155746
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021499-1 Issued in NY
Legal business name
ULTRA HEALTH PT & PTA, PLLC
Doing business as
Ultra Health Physical & Aquatic Therapy
Practice address
53 Brentwood Rd
Suite B
Bay Shore, NY 11706-6923
Phone
(631) 328-5920
Fax
(631) 328-5921
NPI assigned
Feb 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Authorized official

Name
Mr. Edward W Kalten Jr., PTNPI 1932125689
Title
Owner/Director
Phone
(631) 328-5920

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 021499-1 NY Primary
Physical Therapy AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225200000X 003072-1 NY

Addresses

Primary practice location

53 Brentwood Rd
Suite B
Bay Shore, NY 11706-6923

Mailing address

53 Brentwood Rd
Suite B
Bay Shore, NY 11706-6923
Phone (631) 328-5920

Other names 1

  • Ultra Health Physical & Aquatic Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090309000250 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4284790775 Receives reassigned benefits from 1 practitioner
Practice locations: Bay Shore, NY

National Provider Directory

National Provider Directory

Locations

53 Brentwood Rd
Ste B
Bay Shore, NY 11706
Phone (631) 328-5920

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1013155746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 BRENTWOOD RD",
            "address_2": "SUITE B",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066923",
            "telephone_number": "631-328-5920",
            "fax_number": "631-328-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 BRENTWOOD RD",
            "address_2": "SUITE B",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066923",
            "telephone_number": "631-328-5920",
            "fax_number": "631-328-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRA HEALTH PT & PTA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "KALTEN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "631-328-5920",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021499-1",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "003072-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ultra Health Physical & Aquatic Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.