Organization Active NPI

Wise Physical Therapy P.C.

  • Physical Therapy Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1396143202
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
032748 Issued in NY
Legal business name
WISE PHYSICAL THERAPY P.C.
Practice address
30 Bay 17TH St
Brooklyn, NY 11214-3706
Phone
(347) 695-6540
NPI assigned
Dec 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Authorized official

Name
Amr Ahmed, DPTNPI 1063766103
Title
Owner
Phone
(347) 695-6540

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 Therapy Clinic/Center 261QP2000X 032748 NY Primary

Addresses

Primary practice location

30 Bay 17TH St
Brooklyn, NY 11214-3706

Mailing address

30 Bay 17TH St
Brooklyn, NY 11214-3706
Phone (347) 695-6540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150826001330 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2860708500 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

175 Jericho Tpke
Ste 10
Syosset, NY 11791

Practitioners & affiliated clinicians

Practitioners 1

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": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1396143202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BAY 17TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143706",
            "telephone_number": "347-695-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BAY 17TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143706",
            "telephone_number": "347-695-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE PHYSICAL THERAPY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "AMR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-695-6540",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "032748",
            "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 Dec 8, 2014; 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.