Individual provider Active NPI

Dara Melissa Bordman, PT, DPT

  • Physical Therapist
  • Goshen, NY
National Provider Identifier
1124782495
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
055456 Issued in NY
Practice address
2 Glenmere Cove Rd
Goshen, NY 10924-6059
Phone
(845) 291-4740
NPI assigned
Oct 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 055456 NY Primary
Physical Therapy Assistant 225200000X 013166 NY

Addresses

Primary practice location

2 Glenmere Cove Rd
Goshen, NY 10924-6059

Mailing address

5 Melissa CT
Warwick, NY 10990-1051
Phone (845) 699-7454

Other practice location 1

20 Walnut St
Montgomery, NY 12549-2260
Phone (845) 457-5555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260116001055 NY Practitioner - Physical Therapist in Private Practice 9931686318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical Center 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

94 Clowes Ave
Goshen, NY 10924-1923
Phone (845) 615-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
055456NYMDPhysical Therapist
013166NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Dec 10, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Dec 10, 2025 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1634947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1124782495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MELISSA CT",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901051",
            "telephone_number": "845-699-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 GLENMERE COVE RD",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246059",
            "telephone_number": "845-291-4740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "NY",
            "postal_code": "125492260",
            "country_code": "US",
            "telephone_number": "845-457-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORDMAN",
        "first_name": "DARA",
        "middle_name": "MELISSA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-23",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "055456",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "013166",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.