NPIMap

Organization Active NPI

Avenue S Rehab PT PC

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1174168355
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
AVENUE S REHAB PT PC
Practice address
2769 Coney Island Ave # BCM
Brooklyn, NY 11235-5061
Phone
(718) 373-2110
NPI assigned
Nov 12, 2019
Last updated
May 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Authorized official

Name
Mr. Ahmed Fahim Abdrabou, PTNPI 1801395157
Title
President
Phone
(929) 406-4611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2769 Coney Island Ave # BCM
Brooklyn, NY 11235-5061

Mailing address

2015 E 7TH St Apt A9
Brooklyn, NY 11223-3123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200310002392 NY Part B Supplier - Clinic/Group Practice 2062840820 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY; Flushing, NY

National Provider Directory

National Provider Directory

Locations

2088 Flatbush Ave
Brooklyn, NY 11234
Phone (929) 406-4611

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1174168355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 E 7TH ST APT A9",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2769 CONEY ISLAND AVE # BCM",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355061",
            "telephone_number": "718-373-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENUE S REHAB PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-12",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "ABDRABOU",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "FAHIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "929-406-4611",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.