Core Physical Therapy & Sport Rehabilitation PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

021520-1 Issued in NY

Legal business name

CORE PHYSICAL THERAPY & SPORT REHABILITATION PC

Practice address

259 Jefferson Blvd
Staten Island, NY 10312-3001

Phone

(718) 356-2919

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mark Anthony Pacchiano, PT/DPTNPI 1104986223

Title

Owner

Phone

(719) 356-2919

Specialties & licenses 1

Addresses

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.

• Mark Anthony Pacchiano, MSPT, MTC, CSCS

  • Physical Therapist
  • Staten Island, NY
  • NPI 1104986223
  Medicare reassignment Care Compare group NPD Authorized official
• Christine M. Chimento, P.T. DPT

  • Physical Therapist
  • Staten Island, NY
  • NPI 1407818446
  Medicare reassignment Care Compare group NPD
• Jacqueline Mahan, DPT

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1447525993
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1306979075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 JEFFERSON BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123001",
            "telephone_number": "718-356-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 JEFFERSON BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123001",
            "telephone_number": "718-356-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE PHYSICAL THERAPY & SPORT REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "PACCHIANO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-356-2919",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT/DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021520-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Cordero, FNP
• Melissa D Cordero, RN
• Natasha Elisa Cordero
• Nicole Cordero, MS, OTR
• Core Chiropractic PLLC
• Stephanie Ann Corea, OT
• Carla A Coriaty-Hulla, CDN
• Caitlin Coriell
• Kelly Corletto, LMSW
• Lesa May Cormack, LCSW

• Physical Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.