NPIMap

Organization Active NPI

Pro Motion Physical Therapy,P.C.

  • Physical Therapist
  • Monroe, NY
National Provider Identifier
1083724264
Registry record updated Aug 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13282 Issued in NY
Legal business name
PRO MOTION PHYSICAL THERAPY,P.C.
Practice address
1019 State Route 17M
Monroe, NY 10950-1643
Phone
(845) 781-5890
Fax
(845) 781-7916
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2007

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

Authorized official

Name
Miss Nancy Lynne Matthews
Title
Administrator
Phone
(516) 599-4475

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 13282 NY Primary

Addresses

Primary practice location

1019 State Route 17M
Monroe, NY 10950-1643

Mailing address

1019 State Route 17M
Monroe, NY 10950-1643
Phone (845) 781-5890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721001200 NY Part B Supplier - Clinic/Group Practice 3870573835 Receives reassigned benefits from 2 practitioners
Practice locations: Newburgh, NY; Woodhaven, NY; South Ozone Park, NY; Monroe, NY

National Provider Directory

National Provider Directory

Locations

633 Route 211 E
Ste 2
Middletown, NY 10941
Phone (845) 692-3224

1019 State Route 17M
Ste 1
Monroe, NY 10950
Phone (845) 781-5890

1019 State Route 17M
Monroe, NY 10950
Phone (845) 781-5890

12 Hdsn Vly Prof Plz
#1
Newburgh, NY 12550

13508 Lefferts Blvd
South Ozone Park, NY 11420
Phone (718) 322-6290

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187395200000",
    "number": "1083724264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 STATE ROUTE 17M",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501643",
            "telephone_number": "845-781-5890",
            "fax_number": "845-781-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 STATE ROUTE 17M",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501643",
            "telephone_number": "845-781-5890",
            "fax_number": "845-781-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO MOTION PHYSICAL THERAPY,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-08-18",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-599-4475",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "13282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2007; 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.