NPIMap

Organization Active NPI

Rehabilitation Associate PT PC

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1093849929
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
023536 Issued in NY
Legal business name
REHABILITATION ASSOCIATE PT PC
Practice address
2072 Ocean Avenue
Suite 101
Brooklyn, NY 11230
Phone
(718) 616-1450
Fax
(718) 743-8186
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Authorized official

Name
Mr. Mordechai Menachem Shedrowitzky, MS, PTNPI 1578662201
Title
Owner
Phone
(718) 616-1450

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 023536 NY Primary

Addresses

Primary practice location

2072 Ocean Avenue
Suite 101
Brooklyn, NY 11230

Mailing address

2072 Ocean Avenue
Suite 101
Brooklyn, NY 11230
Phone (718) 616-1450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070815000223 NY Part B Supplier - Clinic/Group Practice 6103917463 Receives reassigned benefits from 10 practitioners
Practice locations: Brooklyn, NY; New York, NY; Rockaway Park, NY

National Provider Directory

National Provider Directory

Locations

165 Division Ave
#1
Brooklyn, NY 11211

30 Park Ave
Ste 4
New York, NY 10016
Phone (718) 616-1450

Practitioners & affiliated clinicians

Practitioners 10

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228953600000",
    "number": "1093849929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2072 OCEAN AVENUE",
            "address_2": "SUITE 101",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11230",
            "telephone_number": "718-616-1450",
            "fax_number": "718-743-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2072 OCEAN AVENUE",
            "address_2": "SUITE 101",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11230",
            "telephone_number": "718-616-1450",
            "fax_number": "718-743-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION ASSOCIATE PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-12-11",
        "status": "A",
        "authorized_official_last_name": "SHEDROWITZKY",
        "authorized_official_first_name": "MORDECHAI",
        "authorized_official_middle_name": "MENACHEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-616-1450",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "023536",
            "primary": true
        }
    ],
    "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 Dec 11, 2008; 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.