Individual provider Active NPI

Heather Mims, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1083016554
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
036521 Issued in NY
Practice address
95 University PL FL 8
New York, NY 10003-4515
Phone
(212) 604-1316
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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 036521 NY Primary

Addresses

Primary practice location

95 University PL FL 8
New York, NY 10003-4515

Mailing address

95 University PL FL 8
New York, NY 10003-4515
Phone (212) 604-1316

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141016000430 NY Practitioner - Physical Therapist in Private Practice 8628299633 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lisa Blum Physical Therapy PLLCGroup PAC ID 4981007549, 9 clinicians

Practice addresses (Care Compare)

99 University PL
FL 9
New York, NY 10003-4528
Phone (212) 604-1316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036521NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Blum Physical Therapy PLLC Physical Therapist CurrentSince Jan 10, 2022 Accepting new patients
Shift Physical Therapy, PLLC Physical Therapist CurrentSince Sep 15, 2014 Accepting new patients

Locations

95 University Pl
Fl 8
New York, NY 10003
Phone (212) 604-1316

99 University Pl
Fl 9
New York, NY 10003
Phone (212) 604-1316

Organizations & group practices 2

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": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1083016554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 UNIVERSITY PL FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034515",
            "telephone_number": "212-604-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 UNIVERSITY PL FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034515",
            "telephone_number": "212-604-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "HEATHER",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036521",
            "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 Sep 16, 2014; 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.