Organization Active NPI

New U Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Staten Island, NY
National Provider Identifier
1184916835
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
028006 Issued in NY
Legal business name
NEW U PHYSICAL THERAPY PLLC
Practice address
1835 Richmond Rd
Staten Island, NY 10306-2560
Phone
(718) 502-5271
Fax
(718) 701-1188
NPI assigned
May 12, 2011
Last updated
May 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Authorized official

Name
Dr. Boris Polonskiy, PTNPI 1710910112
Title
Director
Phone
(718) 502-5271

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 Therapy Clinic/Center 261QP2000X 028006 NY Primary

Addresses

Primary practice location

1835 Richmond Rd
Staten Island, NY 10306-2560

Mailing address

1835 Richmond Road
Staten Island, NY 10306
Phone (718) 502-5271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110809000036 NY Part B Supplier - Clinic/Group Practice 5395914378 Receives reassigned benefits from 3 practitioners
Practice locations: Staten Island, NY
O20221020000407 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5395914378 Receives reassigned benefits from 2 practitioners
Practice locations: Freehold, NJ; Piscataway, NJ

National Provider Directory

National Provider Directory

Locations

154 Stelton Rd
Piscataway, NJ 08854
Phone (718) 502-5271

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1184916835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 RICHMOND ROAD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10306",
            "telephone_number": "718-502-5271",
            "fax_number": "718-701-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062560",
            "telephone_number": "718-502-5271",
            "fax_number": "718-701-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW U PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "POLONSKIY",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-502-5271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "028006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.