Individual provider Active NPI

Ulugbek Ganiev, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1053076281
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047995 Issued in NY
Practice address
3319 Avenue N
Brooklyn, NY 11234-2605
Phone
(718) 258-3300
Fax
(718) 258-3301
NPI assigned
Nov 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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 047995 NY Primary

Addresses

Primary practice location

3319 Avenue N
Brooklyn, NY 11234-2605

Mailing address

3319 Avenue N
Brooklyn, NY 11234-2605
Phone (718) 258-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211106000028 NY Practitioner - Physical Therapist in Private Practice 1456740836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Core Physical Therapy Services PCGroup PAC ID 4486087442, 27 clinicians

Practice addresses (Care Compare)

2003 Coney Island Ave
Brooklyn, NY 11223-2328
Phone (917) 723-0667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047995NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Physical Therapy Services PC Physical Therapist CurrentSince Jun 1, 2025 Accepting new patients

Locations

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

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": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1053076281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 AVENUE N",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342605",
            "telephone_number": "718-258-3300",
            "fax_number": "718-258-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 AVENUE N",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342605",
            "telephone_number": "718-258-3300",
            "fax_number": "718-258-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANIEV",
        "first_name": "ULUGBEK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047995",
            "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 Nov 2, 2021; 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.