Physical Medicine and Rehabilitation Mobile PC
Organization Active NPI Physical Medicine & Rehabilitation Physician · Atlantic Beach, NY
NPI 1093540163 · NPPES record last updated Sep 6, 2024
Key facts
- NPI
- 1093540163
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- Legal business name
- PHYSICAL MEDICINE AND REHABILITATION MOBILE PC
- Practice address
- 123 Bayside Dr
Atlantic Beach, NY 11509-1608 - Phone
- (718) 406-6037
- NPI assigned
- Sep 6, 2024
- Organization subpart
- No
Authorized official
- Name
- Jonah Green, MD
- Title
- President
- Phone
- (718) 406-6037
Practitioners 10
-
Jonah Steven Green, M.D.
-
Joshua Simons, MD
-
Adina Bakst, PA
-
Rifa Nanziba, PA-C
-
Rachel Zirman, PA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241002003841 | NY | Part B Supplier - Clinic/Group Practice | 7810428729 |
Receives reassigned benefits from 10 practitioners Practice locations: Uniondale, NY; Rockaway Park, NY; Middle Village, NY; Long Beach, NY; Greenport, NY; Far Rockaway, NY; Brooklyn, NY; Bronx, NY |
National Provider Directory
Locations
1555 Rockaway Pkwy
Brooklyn, NY 11236
Phone (718) 307-5460
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician |
208100000X | Yes |
Addresses
Primary practice location
123 Bayside Dr
Atlantic Beach, NY 11509-1608
Mailing address
620 Wilson Avenue
PMB #95
Brooklyn, NY 11207
Phone (718) 406-6037
Other providers in Atlantic Beach, NY
- Michael J. Miller Otrpc
- Michael Joseph Miller
- Mweb Medical PLLC
- Nathan Begelman, MD, PC
- Nina Perchenok
- Susan B Port
- Margery Ellen Rubin
- Sarnelli Speech Services
- Isabella Sarnelli
- Diane Miller Schulman
All providers in Atlantic Beach, NY · Physical Medicine & Rehabilitation Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.