Individual provider Active NPI

Maryam Farzaneh Alkhas, BS PHYSICAL THERAPY

  • Pediatric Physical Therapist
  • New York, NY
National Provider Identifier
1265686828
Registry record updated Nov 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
012019-1 Issued in NY
Practice address
593 Riverside Dr Apt 3F
New York, NY 10031-8022
Phone
(646) 425-9833
Fax
(212) 283-8627
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 012019-1 NY Primary

Addresses

Primary practice location

593 Riverside Dr Apt 3F
New York, NY 10031-8022

Mailing address

593 Riverside Dr Apt 3F
New York, NY 10031-8022
Phone (646) 425-9833

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250520001862 NY Practitioner - Physical Therapist in Private Practice 3173041431 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
012019NYMDMental Health Counselor
012019-1NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Child Development Resources Inc Pediatrics CurrentSince Mar 7, 2025 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": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226275200000",
    "number": "1265686828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 RIVERSIDE DR APT 3F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100318022",
            "telephone_number": "646-425-9833",
            "fax_number": "212-283-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 RIVERSIDE DR APT 3F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100318022",
            "telephone_number": "646-425-9833",
            "fax_number": "212-283-8627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALKHAS",
        "first_name": "MARYAM",
        "middle_name": "FARZANEH",
        "name_prefix": "Ms.",
        "credential": "BS PHYSICAL THERAPY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2008-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "012019-1",
            "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 Nov 10, 2008; 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.