Individual provider Active NPI

Yisrael Dubin

  • Physical Therapist
  • Englewood, NJ
National Provider Identifier
1124736624
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02137000 Issued in NJ
Practice address
500 Grand Ave Ste 100
Englewood, NJ 07631-4968
Phone
(201) 567-2277
NPI assigned
Nov 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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 40QA02137000 NJ Primary

Addresses

Primary practice location

500 Grand Ave Ste 100
Englewood, NJ 07631-4968

Mailing address

500 Grand Ave Ste 100
Englewood, NJ 07631-4968
Phone (201) 567-2277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221213002655 NJ Practitioner - Physical Therapist in Private Practice 2668841602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Medicine and Rehabilitation Center PAGroup PAC ID 1658273750, 26 clinicians

Practice addresses (Care Compare)

500 Grand Ave
Suite 100
Englewood, NJ 07631-4968
Phone (201) 567-2277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02137000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine and Rehabilitation Center PA Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients

Locations

500 Grand Ave
Ste 100
Englewood, NJ 07631
Phone (201) 227-1760

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": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1124736624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GRAND AVE STE 100",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314968",
            "telephone_number": "201-567-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GRAND AVE STE 100",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314968",
            "telephone_number": "201-567-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBIN",
        "first_name": "YISRAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02137000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.