Individual provider Active NPI

Michael S Zazzali, DSC., PT, OCS

  • Physical Therapist
  • New York, NY
National Provider Identifier
1104988096
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
145801 Issued in NY
Practice address
19 W 21St St
Suite 404
New York, NY 10010-6805
Phone
(212) 366-4450
Fax
(212) 202-3633
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 145801 NY Primary

Addresses

Primary practice location

19 W 21St St
Suite 404
New York, NY 10010-6805

Mailing address

19 W 21St St
Suite 404
New York, NY 10010-6805
Phone (212) 366-4450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120627000688 NY Practitioner - Physical Therapist in Private Practice 8729005806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Physical Therapy Associates of New York LLCGroup PAC ID 9830080373, 2 clinicians

Practice addresses (Care Compare)

19 W 21St St
RM 404
New York, NY 10010-6877
Phone (212) 366-4450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
145801NYMDPhysical Therapist

Organizations & group practices 1

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104988096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 W 21ST ST",
            "address_2": "SUITE 404",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106805",
            "telephone_number": "212-366-4450",
            "fax_number": "212-202-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W 21ST ST",
            "address_2": "SUITE 404",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106805",
            "telephone_number": "212-366-4450",
            "fax_number": "212-202-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAZZALI",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "DSC., PT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "145801",
            "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 Jul 8, 2007; 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.