Active NPI
Alan Wittert, PT, DPT
- Physical Therapist
- Flushing, NY
National Provider Identifier
1043686736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 039366-1
- Practice address
- 6610 149TH St
Apt.4C
Flushing, NY 11367-1353 - Phone
- (646) 209-0515
- NPI assigned
- Aug 17, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 039366-1 | NY | Primary |
Addresses
Primary practice location
6610 149TH St
Apt.4C
Flushing, NY 11367-1353
Mailing address
6610 149TH St
Apt.4C
Flushing, NY 11367-1353
Phone (646) 209-0515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250328002802 | UT | Practitioner - Physical Therapist in Private Practice | 4385954916 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Integrated Clinix
Practice addresses (Care Compare)
4337 W Oxford St
Cedar Hills, UT 84062-8638
Phone (801) 822-1880
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039366-1 | NY | MD | Physical Therapist |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439769600000",
"number": "1043686736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6610 149TH ST",
"address_2": "APT.4C",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113671353",
"telephone_number": "646-209-0515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6610 149TH ST",
"address_2": "APT.4C",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113671353",
"telephone_number": "646-209-0515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTERT",
"first_name": "ALAN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-17",
"last_updated": "2015-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "039366-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; 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.