Individual provider Active NPI

Stefan Sahagun, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1144988627
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
048217
Practice address
2133 Ralph Ave
Brooklyn, NY 11234-5405
Phone
(718) 451-1400
NPI assigned
Dec 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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 048217 Primary

Addresses

Primary practice location

2133 Ralph Ave
Brooklyn, NY 11234-5405

Mailing address

981 US Highway 22 FL 2
Bridgewater, NJ 08807-2946
Phone (201) 801-7141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211213002312 NY Practitioner - Physical Therapist in Private Practice 8426448028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1412 Cortelyou Rd
Brooklyn, NY 11226-5606
Phone (347) 699-1011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048217NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince May 13, 2024 Accepting new patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Dec 2, 2021 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince May 13, 2024 Accepting new patients
One on One Physical Therapy Services PLLC Physical Therapist PastSince Dec 2, 2021 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

2846 Steinway St
Astoria, NY 11103
Phone (347) 424-4503

973 Fulton St
Brooklyn, NY 11238
Phone (718) 230-1180

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

25 Flatbush Ave
Ste 3
Brooklyn, NY 11217
Phone (718) 852-2584

142 Prospect Park W
Brooklyn, NY 11215
Phone (718) 230-1180

2133 Ralph Ave
Brooklyn, NY 11234
Phone (718) 451-1400

1412 Cortelyou Rd
Brooklyn, NY 11226
Phone (347) 699-1011

490 Driggs Ave
Brooklyn, NY 11211
Phone (347) 329-4572

550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737

4543 21st St
Long Island City, NY 11101
Phone (347) 589-8100

231 Beach 116th St
Rockaway Park, NY 11694
Phone (718) 474-2224

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1144988627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 US HIGHWAY 22 FL 2",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072946",
            "telephone_number": "201-801-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345405",
            "telephone_number": "718-451-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHAGUN",
        "first_name": "STEFAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-02",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "048217",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 2, 2021; 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.