Individual provider Active NPI

Keisha John, P.T.

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1033210406
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028641 Issued in NY
Practice address
161 Atlantic Ave
Brooklyn, NY 11201-6720
Phone
(718) 852-6030
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 028641 NY Primary

Addresses

Primary practice location

161 Atlantic Ave
Brooklyn, NY 11201-6720

Mailing address

413 86TH St
2ND Floor
Brooklyn, NY 11209-4707
Phone (718) 921-9721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070212000583 NY Practitioner - Physical Therapist in Private Practice 9133121668 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1336 Utica Ave
Brooklyn, NY 11203-5912
Phone (718) 629-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028641NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Esd PT OT & SLP PLLC Physical Therapist CurrentSince Jun 18, 2019 Accepting new patients
First Class Physical Therapy, P.C. Physical Therapist CurrentSince Jun 22, 2009 Accepting new patients
Parcare Community Health Network Inc CurrentSince Jun 5, 2020 Accepting new patients
Parcare Community Health Network Inc CurrentSince Jun 5, 2020 Accepting new patients
Movement Matters Rehabilitation, OT, PT, PLLC Physical Therapist PastSince Jan 1, 2016 Accepting new patients
Scott Physical Therapy P.C. Physical Therapist Past Accepting new patients

Locations

111 N 7th St
Brooklyn, NY 11249
Phone (718) 384-4002

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

Networks

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

Organizations & group practices 7

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033210406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 86TH ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094707",
            "telephone_number": "718-921-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112016720",
            "telephone_number": "718-852-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "KEISHA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028641",
            "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 8, 2007; 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.