Individual provider Active NPI

Mary Ann Gozar

  • Physical Therapist
  • New York, NY
National Provider Identifier
1164315206
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1752 Park Ave
New York, NY 10035-2811
Phone
(686) 646-1063
NPI assigned
May 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2025

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 NY Primary

Addresses

Primary practice location

1752 Park Ave
New York, NY 10035-2811

Mailing address

1752 Park Ave
New York, NY 10035-2811
Phone (686) 646-1063

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251201001218 NY Practitioner - Physical Therapist in Private Practice 4587157441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2758 Middle Country Rd
Lake Grove, NY 11755-2118

50 Water St
3Rd Floor
New York, NY 10004-6001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026351NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Physical Therapist CurrentSince Sep 15, 2025 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Sep 15, 2025 Accepting new patients

Locations

594 Albany Ave
Brooklyn, NY 11203
Phone (646) 694-6680

50 Water St
Fl 3
New York, NY 10004

1752 Park Ave
New York, NY 10035
Phone (646) 686-0000

Organizations & group practices 3

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": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1164315206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352811",
            "telephone_number": "686-646-1063",
            "fax_number": "686-646-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352811",
            "telephone_number": "686-646-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOZAR",
        "first_name": "MARY ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "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 May 29, 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.