Active NPI
Momentum Physical & Occupational Therapy, PLLC
- Occupational Therapist
- Bronx, NY
National Provider Identifier
1053153106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Legal business name
- MOMENTUM PHYSICAL & OCCUPATIONAL THERAPY, PLLC
- Practice address
- 1870 Grand Concourse FL 2
Bronx, NY 10457-5476 - Phone
- (929) 412-9527
- NPI assigned
- Jun 10, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Clyde Matthew Labial, OTR/L
- Title
- Occupational Therapist
- Phone
- (929) 412-9527
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
1870 Grand Concourse FL 2
Bronx, NY 10457-5476
Mailing address
16414 Goethals Ave
Jamaica, NY 11432-1224
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1870 Grand Concourse
Fl 2
Bronx, NY 10457
Phone (347) 431-3824
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapist
- New York, NY
- NPI 1245928936
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1727827200000",
"number": "1053153106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16414 GOETHALS AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114321224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1870 GRAND CONCOURSE FL 2",
"city": "BRONX",
"state": "NY",
"postal_code": "104575476",
"telephone_number": "929-412-9527"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOMENTUM PHYSICAL & OCCUPATIONAL THERAPY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-06-10",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A",
"authorized_official_last_name": "LABIAL",
"authorized_official_first_name": "CLYDE MATTHEW",
"authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
"authorized_official_telephone_number": "929-412-9527",
"authorized_official_credential": "OTR/L"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.