Organization Active NPI

Back 2 Shape P.T. & O.T., PLLC

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1073022281
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BACK 2 SHAPE P.T. & O.T., PLLC
Practice address
2411 E 2ND St
Brooklyn, NY 11223-6041
Phone
(718) 909-5929
Fax
(718) 942-5753
NPI assigned
Sep 20, 2017
Last updated
Sep 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Machial Kreyner, DPTNPI 1851724405
Title
President
Phone
(718) 909-5929

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)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

2411 E 2ND St
Brooklyn, NY 11223-6041

Mailing address

2411 E 2ND St
Brooklyn, NY 11223-6041

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180124001821 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8921367798 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1073022281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 E 2ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112236041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 E 2ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112236041",
            "telephone_number": "718-909-5929",
            "fax_number": "718-942-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK 2 SHAPE P.T. & O.T., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "KREYNER",
        "authorized_official_first_name": "MACHIAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-909-5929",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 20, 2017; 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.

Verify at the official NPI Registry.