Dynamic Wellness Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

031132 Issued in NY

Legal business name

DYNAMIC WELLNESS PHYSICAL THERAPY PC

Practice address

7217 18TH Ave
Brooklyn, NY 11204-5634

Phone

(718) 837-7581

NPI assigned

Aug 20, 2015

Organization subpart

No

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

Authorized official

Name

Caryl Luisa Tadaba Rasco, DPTNPI 1235445032

Title

President

Phone

(718) 837-7581

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Caryl Luisa Tabada Rasco

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1235445032
  Medicare reassignment NPD Authorized official
• Z-Jy Dela Cruz, PT

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1871052191
  Medicare reassignment NPD

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1376919662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7217 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045634",
            "telephone_number": "718-837-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7217 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045634",
            "telephone_number": "718-837-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC WELLNESS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "RASCO",
        "authorized_official_first_name": "CARYL LUISA",
        "authorized_official_middle_name": "TADABA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-837-7581",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04075590",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dynamic Physical Therapy and Acupuncture, PLLC
• Dynamic Solutions Pediatric Physical & Occupational Therapy
• Dynamic Speech & Language PC
• Dynamic Suppliers, LLC
• Dynamic Therapeutic Care SLP PLLC
• Dynamic Youth Community
• Dynamicare Inc
• Dynasty First Medical PC
• Dynasty Pediatrics PLLC
• Dynasty Social Adult Day Center Inc

• Physical Therapist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.