NPIMap

Organization Active NPI

Ergo Physical Therapy, PC

  • Physical Therapist
  • Forest Hills, NY
National Provider Identifier
1285856898
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ERGO PHYSICAL THERAPY, PC
Practice address
10740 Queens Blvd
Suite 207
Forest Hills, NY 11375-4252
Phone
(718) 261-3100
Fax
(718) 261-2915
NPI assigned
May 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ron Kassab, PHYSICAL THERAPISTNPI 1841306370
Title
Director
Phone
(718) 261-3100

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
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

10740 Queens Blvd
Suite 207
Forest Hills, NY 11375-4252

Mailing address

10740 Queens Blvd
Suite 207
Forest Hills, NY 11375-4252
Phone (718) 261-3100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060120000727 NY Part B Supplier - Clinic/Group Practice 9931123650 Receives reassigned benefits from 15 practitioners
Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory

Locations

10740 Queens Blvd
Ste 207
Forest Hills, NY 11375
Phone (718) 261-3100

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285856898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 QUEENS BLVD",
            "address_2": "SUITE 207",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754252",
            "telephone_number": "718-261-3100",
            "fax_number": "718-261-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10740 QUEENS BLVD",
            "address_2": "SUITE 207",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754252",
            "telephone_number": "718-261-3100",
            "fax_number": "718-261-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERGO PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KASSAB",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-261-3100",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.