Individual provider Active NPI

Talaia Theresa Regist, PT, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1205629391
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
055002 Issued in NY
Practice address
25 Kenilworth PL
Brooklyn, NY 11210-2327
Phone
(917) 370-2036
NPI assigned
May 22, 2025
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 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 055002 NY Primary

Addresses

Primary practice location

25 Kenilworth PL
Brooklyn, NY 11210-2327

Mailing address

25 Kenilworth PL
Brooklyn, NY 11210-2327
Phone (917) 370-2036

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250823000156 NY Practitioner - Physical Therapist in Private Practice 7911407036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Services of Flatiron PCGroup PAC ID 1759784085, 112 clinicians

Practice addresses (Care Compare)

138 5TH Ave
FL 2
New York, NY 10011-4367
Phone (212) 287-4257

1412 Cortelyou Rd
Brooklyn, NY 11226-5606
Phone (347) 699-1011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
055002NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Services of Flatiron PC Physical Therapist CurrentSince Nov 1, 2025 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Aug 14, 2025 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Aug 14, 2025 Accepting new patients

Locations

1412 Cortelyou Rd
Brooklyn, NY 11226
Phone (347) 699-1011

550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737

138 5th Ave
Fl 2
New York, NY 10011
Phone (212) 287-4257

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1205629391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 KENILWORTH PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102327",
            "telephone_number": "917-370-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 KENILWORTH PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102327",
            "telephone_number": "917-370-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGIST",
        "first_name": "TALAIA",
        "middle_name": "THERESA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "055002",
            "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 Aug 15, 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.