Active Mobility Physical Therapy PC

Organization Active NPI Physical Therapist · Bethpage, NY

NPI 1235995408 · NPPES record last updated Jul 30, 2025

Key facts

NPI
1235995408
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
ACTIVE MOBILITY PHYSICAL THERAPY PC
Practice address
59 Martin Rd N
Bethpage, NY 11714-5119
Phone
(516) 680-5484
NPI assigned
Feb 26, 2024
Organization subpart
No

Authorized official

Name
Khurshid Ibrahimi, PT
Title
Director
Phone
(516) 680-5484

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240508003234 NY Part B Supplier - Clinic/Group Practice 8325489362 Receives reassigned benefits from 6 practitioners
Practice locations: Bethpage, NY

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X Yes

Addresses

Primary practice location

59 Martin Rd N
Bethpage, NY 11714-5119

Mailing address

59 Martin Rd N
Bethpage, NY 11714-5119

Other providers in Bethpage, NY

All providers in Bethpage, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.