Active NPI
Justin Matthew Fortunato, P.T.
- Physical Therapist
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 026604-1
- Practice address
- 83 Maiden LN FL 6
New York, NY 10038-4737 - Phone
- (212) 895-3410
- NPI assigned
- May 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 026604-1 | NY | Primary |
Addresses
Primary practice location
83 Maiden LN FL 6
New York, NY 10038-4737
Mailing address
15649 91St St
Howard Beach, NY 11414-2713
Phone (718) 738-5307
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026604-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Priority One Therapy PT OT SLP PLLC | Current | Accepting new patients | |
| Nysarc Inc | Current | Accepting new patients | |
| University Physicians of Brooklyn, Inc. | Past | Accepting new patients |
Locations
83 Maiden Ln
Fl 6
New York, NY 10038
Phone (212) 780-2378
83 Maiden Ln
New York, NY 10038
Phone (212) 780-2578
83 Maiden Ln
Fl 7
New York, NY 10038
Phone (212) 780-2564
83 Maiden Ln
Fl 5
New York, NY 10038
Phone (212) 780-2564
99 W Hawthorne Ave
Ste 210
Valley Stream, NY 11580
Phone (718) 305-1190
Organizations & group practices 3
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.
-
- Voluntary or Charitable Agency
- New York, NY
- NPI 1457450124
-
- Rehabilitation Practitioner
- Oceanside, NY
- NPI 1447517453
-
- Orthopaedic Surgery Physician
- Brooklyn, NY
- NPI 1386691822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459987200000",
"number": "1053528513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15649 91ST ST",
"city": "HOWARD BEACH",
"state": "NY",
"postal_code": "114142713",
"telephone_number": "718-738-5307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 MAIDEN LN FL 6",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100384737",
"telephone_number": "212-895-3410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNATO",
"first_name": "JUSTIN",
"middle_name": "MATTHEW",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2016-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "026604-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.