Individual provider Active NPI

Celia Mak, DPT

  • Physical Therapist
  • Elmhurst, NY
National Provider Identifier
1265862650
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
037199 Issued in NY
Practice address
5205 Van Loon St
Elmhurst, NY 11373-4258
Phone
(718) 880-2385
NPI assigned
Nov 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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 037199 NY Primary

Addresses

Primary practice location

5205 Van Loon St
Elmhurst, NY 11373-4258

Mailing address

5205 Van Loon St
Elmhurst, NY 11373-4258
Phone (347) 738-3317

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150505001028 NY Practitioner - Physical Therapist in Private Practice 7618296187 Reassigns benefits to 1 organization
Practice locations: Oakland Gardens, NY

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Energize Physical Therapy PLLCGroup PAC ID 0143528638, 5 clinicians

Practice addresses (Care Compare)

5205 Van Loon St
Elmhurst, NY 11373-4258
Phone (347) 220-8195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
037199NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Promet Physical Therapy PC Physical Therapist CurrentSince Mar 14, 2015 Accepting new patients
Energize Physical Therapy PLLC Physical Therapist CurrentSince Feb 26, 2016 Accepting new patients
Promet Physical Therapy, PC Physical Therapist PastSince Mar 14, 2015 Accepting new patients
Promet Physical Therapy, PC Physical Therapist Past Accepting new patients

Locations

5205 Van Loon St
Elmhurst, NY 11373
Phone (347) 220-8195

7119 80th St
Ste 8210
Glendale, NY 11385
Phone (718) 554-6610

12308 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 880-2385

6317 Metropolitan Ave
Middle Village, NY 11379
Phone (347) 696-6968

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

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": "1384992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1265862650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 VAN LOON ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734258",
            "telephone_number": "347-738-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 VAN LOON ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734258",
            "telephone_number": "718-880-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAK",
        "first_name": "CELIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-21",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.