Organization Active NPI

Midtown Physical Medicine, PC

  • Physical Medicine & Rehabilitation Physician
  • Brooklyn, NY
National Provider Identifier
1023411048
Registry record updated Oct 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
242798 Issued in NY
Legal business name
MIDTOWN PHYSICAL MEDICINE, PC
Practice address
3500 Nostrand Ave
Brooklyn, NY 11229-5107
Phone
(718) 769-2521
NPI assigned
Oct 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2014

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

Authorized official

Name
Dr. John Michael Ventrudo, MD
Title
Owner
Phone
(718) 769-2521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 242798 NY Primary

Addresses

Primary practice location

3500 Nostrand Ave
Brooklyn, NY 11229-5107

Mailing address

300 Jericho Quadrangle
Suite 320
Jericho, NY 11753-2704
Phone (516) 874-8100

National Provider Directory

National Provider Directory

Locations

300 Jericho Quadrangle
#320
Jericho, NY 11753
Phone (516) 874-8116

300 Jericho Quadrangle
Ste 320
Jericho, NY 11753

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": "1412380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412380800000",
    "number": "1023411048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 JERICHO QUADRANGLE",
            "address_2": "SUITE 320",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532704",
            "telephone_number": "516-874-8100",
            "fax_number": "516-320-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295107",
            "telephone_number": "718-769-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN PHYSICAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-04",
        "last_updated": "2014-10-04",
        "status": "A",
        "authorized_official_last_name": "VENTRUDO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-769-2521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "242798",
            "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 Oct 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.