Individual provider Active NPI

Samuel Warmberg, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1366796336
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
036221 Issued in NY
Practice address
1411 Avenue N
Apt F1
Brooklyn, NY 11230-5963
Phone
(347) 570-9258
NPI assigned
Oct 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P86190 NY
Physical Therapist 225100000X 036221 NY Primary

Addresses

Primary practice location

1411 Avenue N
Apt F1
Brooklyn, NY 11230-5963

Mailing address

1411 Avenue N
Apt F1
Brooklyn, NY 11230-5963
Phone (347) 570-9258

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130613000425 NY Practitioner - Physical Therapist in Private Practice 2769621291 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
On-Site Physical and Occupational Therapy PLLCGroup PAC ID 9931328838, 13 clinicians
Homeside Rehab PT OT SLP LLCGroup PAC ID 7810045309, 45 clinicians

Practice addresses (Care Compare)

120 Park St
Woodmere, NY 11598-2624
Phone (516) 500-1750

441 Route 306
Suite 2
Monsey, NY 10952-1234
Phone (718) 377-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036221NYMDPharmacist
P86190NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince May 20, 2013 Accepting new patients
On-Site Physical & Occupational Therapy, PLLC Physical Therapist CurrentSince Dec 1, 2024 Accepting new patients
Homeside Rehab, PT, OT, SLP LLC Physical Therapist CurrentSince Oct 29, 2018 Accepting new patients

Locations

16 Sumner Pl
Brooklyn, NY 11206
Phone (718) 336-9500

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

441 Route 306
Ste 2
Monsey, NY 10952
Phone (201) 952-4436

296 Route 59
Ste 1225
Suffern, NY 10901

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1366796336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 AVENUE N",
            "address_2": "APT F1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305963",
            "telephone_number": "347-570-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 AVENUE N",
            "address_2": "APT F1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305963",
            "telephone_number": "347-570-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARMBERG",
        "first_name": "SAMUEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "P86190",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036221",
            "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 Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.