Individual provider Active NPI

Max William Braccia, PT, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1396561635
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
053489 Issued in NY
Practice address
81 Washington St
Brooklyn, NY 11201-1411
Phone
(646) 222-9370
NPI assigned
Dec 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 053489 NY Primary

Addresses

Primary practice location

81 Washington St
Brooklyn, NY 11201-1411

Mailing address

31 E 32ND St FL 4
New York, NY 10016-5595
Phone (212) 759-2282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211000869 NY Practitioner - Physical Therapist in Private Practice 5991231144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Buffalo School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spear Physical and Occupational Therapy, LLCGroup PAC ID 6901832112, 582 clinicians

Practice addresses (Care Compare)

81 Washington St
Brooklyn, NY 11201-1411
Phone (646) 222-9370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spear Physical and Occupational Therapy, LLC Physical Therapist CurrentSince Nov 15, 2024 Accepting new patients

Locations

120 E 56th St
Rm 1010
New York, NY 10022
Phone (646) 790-7466

31 E 32nd St
Fl 4
New York, NY 10016
Phone (646) 973-5427

Organizations & group practices 1

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": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1396561635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 E 32ND ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165595",
            "telephone_number": "212-759-2282",
            "fax_number": "212-379-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 WASHINGTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011411",
            "telephone_number": "646-222-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACCIA",
        "first_name": "MAX",
        "middle_name": "WILLIAM",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "053489",
            "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 3, 2024; 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.