Individual provider Active NPI

Fathi Abdelwahab Elnaggar, PT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1205192002
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032612 Issued in NY
Practice address
127 Ridgeway Ave
Staten Island, NY 10314-4729
Phone
(347) 606-3917
Fax
(347) 606-3917
NPI assigned
Apr 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 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 032612 NY Primary

Addresses

Primary practice location

127 Ridgeway Ave
Staten Island, NY 10314-4729

Mailing address

127 Ridgeway Ave
Staten Island, NY 10314-4729
Phone (347) 606-3917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1205192002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 RIDGEWAY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144729",
            "telephone_number": "347-606-3917",
            "fax_number": "347-606-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 RIDGEWAY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144729",
            "telephone_number": "347-606-3917",
            "fax_number": "347-606-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELNAGGAR",
        "first_name": "FATHI",
        "middle_name": "ABDELWAHAB",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-05",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032612",
            "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 Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.