Individual provider Active NPI

Gerard Fiordalisi, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1154394203
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6109 Issued in NY
Practice address
8 McGuinness Blvd S
Brooklyn, NY 11222-4997
Phone
(718) 389-3131
Fax
(718) 389-0625
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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 6109 NY Primary

Addresses

Primary practice location

8 McGuinness Blvd S
Brooklyn, NY 11222-4997

Mailing address

8 McGuinness Blvd S
Brooklyn, NY 11222-4997
Phone (718) 389-3131

Other identifiers 1

IdentifierTypeStateIssuer
02018871MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121218000182 NY Practitioner - Physical Therapist in Private Practice 4284886318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gerard Fiordalisi PT PCGroup PAC ID 8628230596, 3 clinicians

Practice addresses (Care Compare)

8 McGuinness S Blvd
Brooklyn, NY 11222-4997
Phone (718) 389-3131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6109NYMDPhysical Therapist
006109NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gerard Fiordalisi PT PC Physical Therapist CurrentSince Jan 1, 2012 Accepting new patients
Regina Management Co. Inc. Past Accepting new patients

Locations

8 McGuinness Blvd S
Brooklyn, NY 11222
Phone (718) 389-3131

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1154394203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MCGUINNESS BLVD S",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112224997",
            "telephone_number": "718-389-3131",
            "fax_number": "718-389-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MCGUINNESS BLVD S",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112224997",
            "telephone_number": "718-389-3131",
            "fax_number": "718-389-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIORDALISI",
        "first_name": "GERARD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "6109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02018871",
            "state": "NY"
        }
    ],
    "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 Jan 8, 2020; 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.