NPIMap

Organization Active NPI

Elite Physical Therapy Ny PC

  • Physical Therapist
  • Bayside, NY
National Provider Identifier
1265632384
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021328 Issued in NY
Legal business name
ELITE PHYSICAL THERAPY NY PC
Practice address
22215 Northern Blvd
Bayside, NY 11361-3603
Phone
(718) 225-7500
Fax
(718) 225-7555
NPI assigned
Jul 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Fotis TsolisNPI 1871697144
Title
Owner
Phone
(718) 225-7500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 021328 NY Primary

Addresses

Primary practice location

22215 Northern Blvd
Bayside, NY 11361-3603

Mailing address

22215 Northern Blvd
Bayside, NY 11361-3603
Phone (718) 225-7500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091230000062 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3971643750 Receives reassigned benefits from 7 practitioners
Practice locations: Astoria, NY; Bayside, NY; Fresh Meadows, NY

National Provider Directory

National Provider Directory

Locations

22215 Northern Blvd
Ste La
Bayside, NY 11361
Phone (718) 989-8515

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1265632384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22215 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613603",
            "telephone_number": "718-225-7500",
            "fax_number": "718-225-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22215 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613603",
            "telephone_number": "718-225-7500",
            "fax_number": "718-225-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PHYSICAL THERAPY NY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "TSOLIS",
        "authorized_official_first_name": "FOTIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-225-7500"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.