Individual provider Active NPI

Irina Dekhtyar, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1306052691
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
017716 Issued in NY
Practice address
445 Lenox Road, Box 30
Brooklyn, NY 11203-2098
Phone
(718) 270-2811
Fax
(718) 270-1247
NPI assigned
May 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 017716 NY Primary

Addresses

Primary practice location

445 Lenox Road, Box 30
Brooklyn, NY 11203-2098

Mailing address

165 Bay 20TH St Apt 1C
Brooklyn, NY 11214-4667
Phone (718) 621-2498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Downstate Med Center Past Accepting new patients

Organizations & group practices 1

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306052691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 BAY 20TH ST APT 1C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144667",
            "telephone_number": "718-621-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 LENOX ROAD, BOX 30",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032098",
            "telephone_number": "718-270-2811",
            "fax_number": "718-270-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEKHTYAR",
        "first_name": "IRINA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017716",
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.