Individual provider Active NPI

Philip Debaz, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1235486937
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
035256 Issued in NY
Practice address
2133 Ralph Ave
Brooklyn, NY 11234-5405
Phone
(718) 451-1400
NPI assigned
Aug 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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 035256 NY Primary

Addresses

Primary practice location

2133 Ralph Ave
Brooklyn, NY 11234-5405

Mailing address

31 New Dorp LN
Staten Island, NY 10306-2351
Phone (718) 370-3500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120824000599 NY Practitioner - Physical Therapist in Private Practice 2365699493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8411 13TH Ave
Brooklyn, NY 11228-3340
Phone (718) 331-2667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035256NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Extra Step Physical Therapy PC Physical Therapist CurrentSince Feb 20, 2014 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1235486937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 NEW DORP LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062351",
            "telephone_number": "718-370-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345405",
            "telephone_number": "718-451-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBAZ",
        "first_name": "PHILIP",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035256",
            "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 13, 2012; 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.