Individual provider Active NPI

Mourad Nakhla

  • Physical Therapist
  • Jamaica, NY
National Provider Identifier
1215790126
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
022945 Issued in NY
Practice address
17119 Hillside Avenue
Auc Physical Therapy
Jamaica, NY 11432
Phone
(718) 400-7000
NPI assigned
Feb 2, 2024
Last updated
Feb 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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 022945 NY Primary

Addresses

Primary practice location

17119 Hillside Avenue
Auc Physical Therapy
Jamaica, NY 11432

Mailing address

188 Kensington Ave
Norwood, NJ 07648-1706

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806003568 NY Practitioner - Physical Therapist in Private Practice 9032656152 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022945NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Motion Rehabilitation OT PC CurrentSince Jul 1, 2024 Accepting new patients
Bishay Physical Therapy P.C. Physical Therapist CurrentSince Nov 3, 2024 Accepting new patients
Garas Physical Therapy PC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
St.Thomas Physical Therapy,PC. Physical Therapist PastSince Feb 4, 2024 Accepting new patients

Organizations & group practices 4

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": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1215790126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 KENSINGTON AVE",
            "city": "NORWOOD",
            "state": "NJ",
            "postal_code": "076481706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17119 HILLSIDE AVENUE",
            "address_2": "AUC PHYSICAL THERAPY",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-400-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKHLA",
        "first_name": "MOURAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.