Individual provider Active NPI

Yasser A. Abdalla, DPT, PHD

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1023364007
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
030908 Issued in NY
Practice address
1905 Bay Ridge Pkwy Apt 1R
Brooklyn, NY 11204-5715
Phone
(347) 788-2430
Fax
(347) 602-4631
NPI assigned
Jul 27, 2012
Last updated
Jan 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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 030908 NY Primary

Addresses

Primary practice location

1905 Bay Ridge Pkwy Apt 1R
Brooklyn, NY 11204-5715

Mailing address

1905 Bay Ridge Pkwy Apt 1R
Brooklyn, NY 11204-5715
Phone (347) 788-2430

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120816000865 NY Practitioner - Physical Therapist in Private Practice 8224284633 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Optimized Independence OT PLLC Physical Therapist CurrentSince Nov 6, 2020 Accepting new patients
Block Institute, Inc. CurrentSince Aug 23, 2019 Accepting new patients

Locations

2214 Stillwell Ave
Brooklyn, NY 11223
Phone (718) 372-7227

376 Bay 44th St
Brooklyn, NY 11214
Phone (718) 906-5400

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1023364007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 BAY RIDGE PKWY APT 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045715",
            "telephone_number": "347-788-2430",
            "fax_number": "347-602-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 BAY RIDGE PKWY APT 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045715",
            "telephone_number": "347-788-2430",
            "fax_number": "347-602-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALLA",
        "first_name": "YASSER",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DPT, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030908",
            "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 Jan 29, 2013; 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.