Grasmere Physical Therapy Wellness, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

GRASMERE PHYSICAL THERAPY WELLNESS, PLLC

Practice address

1130 Victory Blvd
Staten Island, NY 10301-3623

Phone

(718) 442-1003

Fax

(718) 442-1150

NPI assigned

Feb 26, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Igor Tserlyuk, DPTNPI 1568711802

Title

Physical Therapist/Owner

Phone

(718) 442-1003

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 3

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

• Igor Tserlyuk, DPT

  • Physical Therapist
  • Staten Island, NY
  • NPI 1568711802
  Medicare reassignment Care Compare group NPD Authorized official
• Sakshi Korgaonkar

  • Physical Therapist
  • Staten Island, NY
  • NPI 1568235760
  Medicare reassignment Care Compare group NPD
• Viveki Pandya, PT

  • Physical Therapist
  • Staten Island, NY
  • NPI 1215507579
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1306643598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013623",
            "telephone_number": "718-442-1003",
            "fax_number": "718-442-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013623",
            "telephone_number": "718-442-1003",
            "fax_number": "718-442-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRASMERE PHYSICAL THERAPY WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "TSERLYUK",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "718-442-1003",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215507579",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1568235760",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irene Grant, LPN
• Nicole Grant
• Shyelle Gabrielle Grant, RN
• Tyler Grantham, MD
• Grasmere Physical Therapy and Rehabilitation, PLLC
• Grasmere Sleep Lab Corp
• Elysha Rand Grauman, PA
• Brianna N Gravagna
• Nichole Francine Graves-McLeod, LMSW
• Badri Anthony Gravesande, PA

• Physical Therapy Clinic/Center in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.