Organization Active NPI

Nola Physical Therapy, P.C.

  • Physical Therapist
  • New York, NY
National Provider Identifier
1366683054
Registry record updated Mar 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
022090-1 Issued in NY
Legal business name
NOLA PHYSICAL THERAPY, P.C.
Practice address
2 W 45TH St Ste 208
New York, NY 10036-4268
Phone
(212) 840-6652
Fax
(212) 840-6022
NPI assigned
Mar 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2009

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

Authorized official

Name
Jason Gromelski, PT, MPT, ATC-L, CSCS
Title
Physical Therapist, Owner
Phone
(212) 840-6652

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 022090-1 NY Primary

Addresses

Primary practice location

2 W 45TH St Ste 208
New York, NY 10036-4268

Mailing address

2 W 45TH St Ste 208
New York, NY 10036-4268
Phone (212) 840-6652

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091027000183 NY Part B Supplier - Clinic/Group Practice 5092852913 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

2 W 45th St
Ste 208
New York, NY 10036
Phone (212) 840-6652

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": "1236643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236643200000",
    "number": "1366683054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W 45TH ST STE 208",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100364268",
            "telephone_number": "212-840-6652",
            "fax_number": "212-840-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W 45TH ST STE 208",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100364268",
            "telephone_number": "212-840-6652",
            "fax_number": "212-840-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOLA PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-10",
        "last_updated": "2009-03-10",
        "status": "A",
        "authorized_official_last_name": "GROMELSKI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "212-840-6652",
        "authorized_official_credential": "PT, MPT, ATC-L, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022090-1",
            "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 Mar 10, 2009; 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.