NPIMap

Organization Active NPI

Physical Medicine and Rehabilitation Associates of Staten Island LLP

  • Specialist
  • Staten Island, NY
National Provider Identifier
1285842815
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
182903 Issued in NY
Legal business name
PHYSICAL MEDICINE AND REHABILITATION ASSOCIATES OF STATEN ISLAND LLP
Practice address
361 Edison St
Staten Island, NY 10306-3043
Phone
(718) 980-0101
Fax
(718) 980-1641
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Authorized official

Name
Dr. Perry Dean Drucker, M.D.NPI 1528034428
Title
Partner-Owner
Phone
(718) 908-0101

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 182903 NY Primary

Addresses

Primary practice location

361 Edison St
Staten Island, NY 10306-3043

Mailing address

361 Edison St
Staten Island, NY 10306-3043
Phone (718) 980-0101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080325000000 NY Part B Supplier - Clinic/Group Practice 3173609708 Receives reassigned benefits from 4 practitioners
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229385600000",
    "number": "1285842815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063043",
            "telephone_number": "718-980-0101",
            "fax_number": "718-980-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063043",
            "telephone_number": "718-980-0101",
            "fax_number": "718-980-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE AND REHABILITATION ASSOCIATES OF STATEN ISLAND LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2008-12-16",
        "status": "A",
        "authorized_official_last_name": "DRUCKER",
        "authorized_official_first_name": "PERRY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PARTNER-OWNER",
        "authorized_official_telephone_number": "718-908-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "182903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.