NPIMap

Organization Active NPI

Wellness Den Physical Therapy PLLC

  • Physical Therapist
  • New York, NY
National Provider Identifier
1326748724
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
WELLNESS DEN PHYSICAL THERAPY PLLC
Practice address
177 E 87TH St Ste 202-206
New York, NY 10128-2226
Phone
(212) 292-7117
NPI assigned
Mar 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Jennifer Chan
Title
Coo
Phone
(212) 980-2963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

177 E 87TH St Ste 202-206
New York, NY 10128-2226

Mailing address

485 Madison Ave FL 8
New York, NY 10022-5803
Phone (212) 980-2963

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230929000171 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0446604144 Receives reassigned benefits from 4 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

177 E 87th St
Ste 202
New York, NY 10128

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1326748724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 MADISON AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225803",
            "telephone_number": "212-980-2963",
            "fax_number": "646-858-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 E 87TH ST STE 202-206",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282226",
            "telephone_number": "212-292-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS DEN PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "212-980-2963"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.