Premier East Physical Medicine and Rehabilitation, PC

Primary specialty

Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081N0008X

License

207587 Issued in NY

Legal business name

PREMIER EAST PHYSICAL MEDICINE AND REHABILITATION, PC

Practice address

2920 Route 112
Medford, NY 11763-1451

Phone

(631) 698-3500

Fax

(631) 698-3600

NPI assigned

Jun 28, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Raj Tolat, MDNPI 1902966021

Title

Owner

Phone

(631) 698-3500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 6

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

• Geraldine Abonete Beltran, PT

  • Physical Therapist
  • Deer Park, NY
  • NPI 1740246479
  Medicare reassignment Care Compare group NPD
• Lisa Daley, MD

  • Physical Medicine & Rehabilitation Physician
  • Bellmore, NY
  • NPI 1477580058
  Medicare reassignment Care Compare group NPD
• Steven Ross, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Rego Park, NY
  • NPI 1760749196
  Medicare reassignment Care Compare group NPD
• Raj Tolat, MD

  • Physical Medicine & Rehabilitation Physician
  • Valley Stream, NY
  • NPI 1902966021
  Medicare reassignment NPD Authorized official
• Xiaoxia Gao, P.T.

  • Physical Therapist
  • Ronkonkoma, NY
  • NPI 1750552618
  Medicare reassignment NPD
• Michelle Lynn Eaton, P.T.

  • Physical Therapist
  • Hauppauge, NY
  • NPI 1558424549
  Care Compare group

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586217600000",
    "number": "1275829202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9308",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115309308",
            "telephone_number": "516-294-4590",
            "fax_number": "516-294-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 ROUTE 112",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631451",
            "telephone_number": "631-698-3500",
            "fax_number": "631-698-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EAST PHYSICAL MEDICINE AND REHABILITATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-28",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A",
        "authorized_official_last_name": "TOLAT",
        "authorized_official_first_name": "RAJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-698-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081N0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "NY",
            "license": "207587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Pop, DDS
• Scott Portnoy
• Arthesa Scarlata Portorreal
• Domenica Disalvo Potter, O.T.
• Tithiporn Premaskul, RPH
• Stephanie Principe, RN
• Priolo and Berns Chiropractic PLLC
• Kristan Probeck, RN, MS, ANP
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy, P.C.

• Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician in Medford, NY
• Providers in Medford, NY by specialty
• Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.