NPIMap

Organization Active NPI

Civil Physical Therapy, PLLC

  • Orthopedic Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1336786417
Registry record updated Dec 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
CIVIL PHYSICAL THERAPY, PLLC
Practice address
310 Clarkson Ave Apt 208
Brooklyn, NY 11226-2999
Phone
(347) 815-5228
NPI assigned
Dec 8, 2019
Last updated
Dec 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2019

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

Authorized official

Name
Dr. Clifford Civil, PT, DPT, OCSNPI 1427483825
Title
Owner
Phone
(347) 815-5228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

310 Clarkson Ave Apt 208
Brooklyn, NY 11226-2999

Mailing address

310 Clarkson Ave Apt 208
Brooklyn, NY 11226-2999
Phone (347) 815-5228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200123000992 NY Part B Supplier - Clinic/Group Practice 3274968169 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY
O20230110002462 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3274968169 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

5881 Glenridge Dr
Ste 220
Sandy Springs, GA 30328
Phone (404) 481-3732

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1575763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575763200000",
    "number": "1336786417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 CLARKSON AVE APT 208",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262999",
            "telephone_number": "347-815-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CLARKSON AVE APT 208",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262999",
            "telephone_number": "347-815-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIVIL PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-08",
        "last_updated": "2019-12-08",
        "certification_date": "2019-12-08",
        "status": "A",
        "authorized_official_last_name": "CIVIL",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-815-5228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, OCS"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "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 Dec 8, 2019; 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.