Individual provider Active NPI

Jerome Cabahug

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1043549769
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021242 Issued in NY
Practice address
1414 Newkirk Ave
Brooklyn, NY 11226-6599
Phone
(718) 434-4311
Fax
(718) 434-4355
NPI assigned
Dec 8, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 021242 NY Primary

Addresses

Primary practice location

1414 Newkirk Ave
Brooklyn, NY 11226-6599

Mailing address

1414 Newkirk Ave
Brooklyn, NY 11226-6599
Phone (718) 434-4311

Other practice location 1

275 Central Avenue
Valley Stream, NY 11580
Phone (718) 575-0300 ext. 210

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101026000176 NY Practitioner - Physical Therapist in Private Practice 7315130010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RB Physical and Occupational Therapy, PLLCGroup PAC ID 5294870226, 312 clinicians

Practice addresses (Care Compare)

4010 Ave U
Brooklyn, NY 11234-5118
Phone (718) 692-1155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021242NYMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Sep 6, 2019 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

1414 Newkirk Ave
Brooklyn, NY 11226
Phone (718) 434-4311

2565 E 17th St
Brooklyn, NY 11235
Phone (347) 492-4083

4010 Avenue U
Brooklyn, NY 11234
Phone (718) 692-1155

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

Organizations & group practices 1

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": "1260230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1043549769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 NEWKIRK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112266599",
            "telephone_number": "718-434-4311",
            "fax_number": "718-434-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 NEWKIRK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112266599",
            "telephone_number": "718-434-4311",
            "fax_number": "718-434-4355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Central Avenue",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "11580",
            "country_code": "US",
            "telephone_number": "718-575-0300 x210",
            "fax_number": "718-575-3559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABAHUG",
        "first_name": "JEROME",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021242",
            "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 Mar 17, 2018; 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.