NPIMap

Organization Active NPI

Performance Rehabilitation PT PLLC

  • Physical Therapist
  • Yonkers, NY
National Provider Identifier
1366526519
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PERFORMANCE REHABILITATION PT PLLC
Practice address
955 Yonkers Ave
Ste 109
Yonkers, NY 10704-3060
Phone
(914) 776-7310
Fax
(914) 776-7566
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Steven Wayne Srebnik, MS, PT CHTNPI 1437250024
Title
Owner / President
Phone
(914) 776-7310

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

955 Yonkers Ave
Ste 109
Yonkers, NY 10704-3060

Mailing address

955 Yonkers Ave
Ste 109
Yonkers, NY 10704-3060
Phone (914) 776-7310

Other identifiers 4

IdentifierTypeStateIssuer
G494708OtherNYOXFORD HEALTH PLAN
2122316OtherNEUNITED HEALTHCARE
5080104OtherNYAETNA PPO / POS
30201OtherNYORTHONET

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150630000059 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9830080969 Receives reassigned benefits from 4 practitioners
Practice locations: Yonkers, NY

National Provider Directory

National Provider Directory

Locations

955 Yonkers Ave
Ste 109
Yonkers, NY 10704
Phone (914) 776-7310

Practitioners & affiliated clinicians

Practitioners 5

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": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1366526519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 YONKERS AVE",
            "address_2": "STE 109",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107043060",
            "telephone_number": "914-776-7310",
            "fax_number": "914-776-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 YONKERS AVE",
            "address_2": "STE 109",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107043060",
            "telephone_number": "914-776-7310",
            "fax_number": "914-776-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE REHABILITATION PT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "SREBNIK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "914-776-7310",
        "authorized_official_credential": "MS, PT CHT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "G494708",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2122316",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO / POS",
            "identifier": "5080104",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET",
            "identifier": "30201",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.