Individual provider Active NPI

Paul E Palestis, P.T. O.C.S.

  • Orthopedic Physical Therapist
  • New York, NY
National Provider Identifier
1083744874
Registry record updated Sep 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
019075-1 Issued in NY
Practice address
1727 Broadway
2ND Floor
New York, NY 10019-5214
Phone
(212) 765-4800
Fax
(212) 765-4855
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 019075-1 NY Primary

Addresses

Primary practice location

1727 Broadway
2ND Floor
New York, NY 10019-5214

Mailing address

1015 Saw Mill River Rd
Ardsley, NY 10502-1118
Phone (914) 400-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180413000830 NJ Practitioner - Physical Therapist in Private Practice 5890783419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

210 N Ave E
Cranford, NJ 07016-2491
Phone (908) 276-0237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019075-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network, Inc. Orthopedic CurrentSince Mar 26, 2018 Accepting new patients
Ivyrehab Network Inc. Orthopedic CurrentSince Mar 26, 2018 Accepting new patients

Locations (25 of 49)

15 Newark Ave
Ste 101
Belleville, NJ 07109

1255 Broad St
Ste 207
Bloomfield, NJ 07003
Phone (973) 771-9500

243 US Highway 130
Ste 100
Bordentown, NJ 08505
Phone (609) 400-1630

70 Manheim Ave
Ste 3
Bridgeton, NJ 08302
Phone (856) 455-9700

1436 Route 70 E
Cherry Hill, NJ 08034
Phone (856) 429-8000

95 W Main St
Ste 6
Chester, NJ 07930
Phone (908) 879-7364

95 W Main St
Ste 1
Chester, NJ 07930
Phone (908) 879-7364

2200 Wallace Blvd
Ste E
Cinnaminson, NJ 08077
Phone (856) 829-0015

1011 Clifton Ave
Clifton, NJ 07013
Phone (973) 471-8200

925 Clifton Ave
Ste 102
Clifton, NJ 07013
Phone (973) 330-0705

23204 Columbus Rd
Columbus, NJ 08022
Phone (609) 324-1200

210 North Ave E
Cranford, NJ 07016
Phone (908) 272-6300

210 North Ave E
Ste 1
Cranford, NJ 07016
Phone (908) 276-0237

579 Cranbury Rd
Ste C
East Brunswick, NJ 08816
Phone (732) 432-0733

300 Princeton Hightstown Rd
Ste 201
East Windsor, NJ 08520
Phone (609) 426-4442

45 Broad St
Elmer, NJ 08318
Phone (856) 358-6200

15 Nathaniel Pl
Englewood, NJ 07631
Phone (201) 731-8580

187 Columbia Tpke
Florham Park, NJ 07932
Phone (973) 377-5655

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

795 Franklin Ave
Ste 1
Franklin Lakes, NJ 07417
Phone (201) 847-8585

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

108 Bilby Rd
Ste 201
Hackettstown, NJ 07840
Phone (908) 684-5646

450 Amwell Rd
Ste 7
Hillsborough, NJ 08844
Phone (908) 359-3744

79 Hudson St
Ste 402
Hoboken, NJ 07030
Phone (201) 792-1170

254 Newark Ave
Jersey City, NJ 07302
Phone (551) 222-4396

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1083744874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 SAW MILL RIVER RD",
            "city": "ARDSLEY",
            "state": "NY",
            "postal_code": "105021118",
            "telephone_number": "914-400-1500",
            "fax_number": "914-400-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 BROADWAY",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195214",
            "telephone_number": "212-765-4800",
            "fax_number": "212-765-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALESTIS",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "P.T. O.C.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "019075-1",
            "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 Sep 21, 2017; 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.