Individual provider Active NPI

Dirk F Hartog, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1255567590
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031407-1 Issued in NY
Practice address
53 Columbus Ave
New York, NY 10023-6909
Phone
(212) 541-8450
Fax
(212) 541-8582
NPI assigned
Jun 1, 2009
Last updated
Jun 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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 031407-1 NY Primary

Addresses

Primary practice location

53 Columbus Ave
New York, NY 10023-6909

Mailing address

53 Columbus Ave
New York, NY 10023-6909
Phone (212) 541-8450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090629000024 NY Practitioner - Physical Therapist in Private Practice 0749331080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Marika Molnar Physical Therapist PCGroup PAC ID 4688646847, 9 clinicians

Practice addresses (Care Compare)

53 Columbus Ave
Suite 4
New York, NY 10023-6909
Phone (212) 541-8450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031407NYMDDentist
031407-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marika Molnar Physical Therapist PC CurrentSince May 8, 2009 Accepting new patients

Locations

53 Columbus Ave
Ste 4
New York, NY 10023
Phone (212) 541-8450

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, 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": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1255567590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 COLUMBUS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236909",
            "telephone_number": "212-541-8450",
            "fax_number": "212-541-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 COLUMBUS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236909",
            "telephone_number": "212-541-8450",
            "fax_number": "212-541-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTOG",
        "first_name": "DIRK",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-01",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031407-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.