Active NPI
Mohamed Hafad Elhamadany, PT, PHD
- Pediatric Physical Therapist
- Brooklyn, NY
National Provider Identifier
1124336995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 2236
- Practice address
- 530 Ovington Ave
Apt # 2R
Brooklyn, NY 11209-1725 - Phone
- (646) 549-8170
- Fax
- (718) 745-1492
- NPI assigned
- Sep 15, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 2236 | ND | Primary |
| Physical Therapist | 225100000X | 032846-1 | NY |
Addresses
Primary practice location
530 Ovington Ave
Apt # 2R
Brooklyn, NY 11209-1725
Mailing address
5433 Chestnut St
Grand Forks, ND 58201-8005
Phone (646) 549-8170
Other practice location 1
2810 19th Ave S
Grand Forks, ND 58201-5957
Phone (701) 222-3175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1482541 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, ND
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032846-1 | NY | MD | Physical Therapist |
| 2236 | ND | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Cerebral Palsy of New York City Inc | Current | Accepting new patients | |
| Red Door Pediatric Therapy, Inc | Physical Therapist | Current | Accepting new patients |
| Life Skills and Transition Center | Past | Accepting new patients | |
| Solutions Counseling Services, Inc. | Past | Accepting new patients |
Locations
2810 19th Ave S
Grand Forks, ND 58201
Phone (701) 222-3175
175 Lawrence Ave
Brooklyn, NY 11230
Phone (718) 436-7600
80 Maiden Ln
Fl 12
New York, NY 10038
Interoperability endpoints
- mohamed.elhamadany.p2@direct.ucpnyc.nextgenshare.com
Organizations & group practices 4
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.
-
- Rehabilitation Clinic/Center
- New York, NY
- NPI 1730302019
-
- Speech-Language Pathologist
- Bismarck, ND
- NPI 1639257033
Physical Therapist
-
- Community/Behavioral Health Agency
- Grafton, ND
- NPI 1023751971
-
- Professional Counselor
- Breckenridge, MN
- NPI 1578614038
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1124336995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5433 CHESTNUT ST",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582018005",
"telephone_number": "646-549-8170",
"fax_number": "718-745-1492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 OVINGTON AVE",
"address_2": "APT # 2R",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112091725",
"telephone_number": "646-549-8170",
"fax_number": "718-745-1492"
}
],
"practiceLocations": [
{
"address_1": "2810 19th Ave S",
"address_purpose": "LOCATION",
"city": "Grand Forks",
"state": "ND",
"postal_code": "582015957",
"country_code": "US",
"telephone_number": "701-222-3175",
"fax_number": "701-222-3186",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELHAMADANY",
"first_name": "MOHAMED",
"middle_name": "HAFAD",
"name_prefix": "Dr.",
"credential": "PT, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-15",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "ND",
"license": "2236",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "032846-1",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1482541",
"state": "ND"
}
],
"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 5, 2024; 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.