Active NPI
Ellis Masterman
- Physical Therapist
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 490 Driggs Ave
Brooklyn, NY 11211-2019 - Phone
- (718) 230-1180
- NPI assigned
- Sep 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
490 Driggs Ave
Brooklyn, NY 11211-2019
Mailing address
1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048565 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path | Physical Therapist | Current | Accepting new patients |
| Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC | Current | Accepting new patients |
Locations
490 Driggs Ave
Brooklyn, NY 11211
Phone (347) 329-4572
142 Prospect Park W
Brooklyn, NY 11215
Phone (718) 230-1180
550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737
1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838
Organizations & group practices 2
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.
-
- Physical Therapist
- Harrison, NY
- NPI 1396799409
-
- Physical Medicine & Rehabilitation Physician
- New York, NY
- NPI 1215637699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1275201469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 MAMARONECK AVE STE 140",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106055224",
"telephone_number": "914-294-4050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 DRIGGS AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112112019",
"telephone_number": "718-230-1180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTERMAN",
"first_name": "ELLIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-01",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.