NPIMap

Organization Active NPI

Lisa Blum Physical Therapy PLLC

  • Physical Therapist
  • New York, NY
National Provider Identifier
1346823069
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LISA BLUM PHYSICAL THERAPY PLLC
Practice address
99 University PL FL 9
New York, NY 10003-4528
Phone
(212) 604-1316
NPI assigned
Apr 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Lisa Blum, PT, DPTNPI 1891260402
Title
Owner
Phone
(516) 765-5748

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
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

99 University PL FL 9
New York, NY 10003-4528

Mailing address

96 Frankel Rd
Massapequa, NY 11758-7261
Phone (516) 225-4853

Other names 1

  • Tula Physical Therapy Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211214000290 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4981007549 Receives reassigned benefits from 8 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

99 University Pl
Fl 9
New York, NY 10003
Phone (212) 604-1316

Practitioners & affiliated clinicians

Practitioners 10

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": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1346823069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 FRANKEL RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117587261",
            "telephone_number": "516-225-4853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 UNIVERSITY PL FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034528",
            "telephone_number": "212-604-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA BLUM PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-765-5748",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tula Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 30, 2021; 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.