Individual provider Active NPI

Jonathan N Bacharach, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1144416058
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
029697-1 Issued in NY
Practice address
897 Broadway
Lower Level
New York, NY 10003-1205
Phone
(212) 673-7878
Fax
(212) 674-7878
NPI assigned
Sep 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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 029697-1 NY Primary

Addresses

Primary practice location

897 Broadway
Lower Level
New York, NY 10003-1205

Mailing address

6319 Fly Rd
Suite 3
East Syracuse, NY 13057-9326
Phone (315) 410-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029697-1NYMDPhysical Therapist
029697NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encompass Health Rehabilitation Hospital of Florence, Inc. Past Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist PastSince Dec 11, 2013 Accepting new patients

Organizations & group practices 2

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": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1144416058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6319 FLY RD",
            "address_2": "SUITE 3",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579326",
            "telephone_number": "315-410-6200",
            "fax_number": "315-451-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 BROADWAY",
            "address_2": "LOWER LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031205",
            "telephone_number": "212-673-7878",
            "fax_number": "212-674-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHARACH",
        "first_name": "JONATHAN",
        "middle_name": "N",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029697-1",
            "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 Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.