Ivan Tam, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

047376 Issued in NY

Practice address

412 Market St
Nanuet, NY 10954-2744

Phone

(718) 552-7267

NPI assigned

Nov 3, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, NY, NJ3 enrollments

Enrollment records 3

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Ivyrehab Physical Therapy, Occupational Therapy and Speech Language PAGroup PAC ID 7012997638, 385 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path

  • Physical Therapist
  • Harrison, NY
  • NPI 1396799409
  Medicare reassignment Care Compare group NPD
• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274
  Medicare reassignment Care Compare group
• DG Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Chelmsford, MA
  • NPI 1295279198

  Physical Therapist

  Medicare reassignment NPD
• Pro Staff Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Nutley, NJ
  • NPI 1265750871
  Medicare reassignment
• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1215637699
  NPD
• DG Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • North Grafton, MA
  • NPI 1881270544
  NPD
• Ivyrehab Network Inc

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1861623753
  NPD
• Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cranford, NJ
  • NPI 1699590265

  Physical Therapist

  NPD

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1104581248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 SHORE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112146619",
            "telephone_number": "718-552-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 MARKET ST",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542744",
            "telephone_number": "718-552-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-03",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02326900",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "26504",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmund Tyron Symister, LPN
• Kelly Szeles
• Joseph Anthony Taccetta, D.C.
• Taffuri Chiropractic, P.C.
• Kelsey N Talmadge
• Rachel Ann Tasaro
• TCG Enterprises Inc.
• Elyse Teicher, M.D.
• Bridget Teller
• Irma Nevskine Tertulien, RN

• Physical Therapist in Nanuet, NY
• Providers in Nanuet, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.