Individual provider Active NPI

Mitchell Issac Trestman, DPT

  • Physical Therapist
  • Spring Valley, NY
National Provider Identifier
1306555008
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
049782 Issued in NY
Practice address
2000 Fountainview Dr.
Spring Valley, NY 10977-1097
Phone
(443) 802-6639
NPI assigned
Nov 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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 049782 NY Primary

Addresses

Primary practice location

2000 Fountainview Dr.
Spring Valley, NY 10977-1097

Mailing address

12 Barnacle Dr
Spring Valley, NY 10977-1727
Phone (443) 802-6639

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221207002307 NY Practitioner - Physical Therapist in Private Practice 8628447075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Link Home Therapy Services of Ny-PT OT SLP PLLCGroup PAC ID 2466704713, 42 clinicians

Practice addresses (Care Compare)

108 S Franklin Ave
Suite 10
Valley Stream, NY 11580-6105
Phone (718) 650-6230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049782NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Link Home Therapy Services of Ny-PT OT SLP PLLC CurrentSince Nov 15, 2022 Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580

945 N Central Ave
Woodmere, NY 11598
Phone (267) 223-4867

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1306555008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BARNACLE DR",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109771727",
            "telephone_number": "443-802-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 FOUNTAINVIEW DR.",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109771097",
            "telephone_number": "443-802-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRESTMAN",
        "first_name": "MITCHELL",
        "middle_name": "ISSAC",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.