Individual provider Active NPI

Mira Chanowitz, DPT

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1013605757
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
049298-01 Issued in NY
Practice address
1250 Waters PL
Bronx, NY 10461-2720
Phone
(718) 409-9444
NPI assigned
May 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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 049298-01 NY Primary

Addresses

Primary practice location

1250 Waters PL
Bronx, NY 10461-2720

Mailing address

200 W 93Rd St Apt 3a
New York, NY 10025-7405

Other practice location 1

200 W 93rd St Apt 3A
New York, NY 10025-7405
Phone (732) 453-4494

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250404000159 NY Practitioner - Physical Therapist in Private Practice 1153845730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049298-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 23, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Jan 23, 2025 Accepting new patients

Locations

1250 Waters Pl
Bronx, NY 10461
Phone (718) 409-9444

1250 Waters Pl
Ste 501
Bronx, NY 10461
Phone (718) 409-9444

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1013605757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 93RD ST APT 3A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100257405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WATERS PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612720",
            "telephone_number": "718-409-9444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W 93rd St Apt 3A",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100257405",
            "country_code": "US",
            "telephone_number": "732-453-4494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANOWITZ",
        "first_name": "MIRA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049298-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.