Individual provider Active NPI

Marta M Mamos, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1417137928
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
029033-1 Issued in NY
Practice address
119 W 57TH St
Suite 212
New York, NY 10019-2303
Phone
(212) 421-1740
Fax
(212) 421-1750
NPI assigned
Nov 13, 2007
Last updated
Mar 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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 029033-1 NY Primary

Addresses

Primary practice location

119 W 57TH St
Suite 212
New York, NY 10019-2303

Mailing address

119 W 57TH St
Suite 212
New York, NY 10019-2303
Phone (212) 421-1740

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080118000220 NY Practitioner - Physical Therapist in Private Practice 4284715004 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029033-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cynergy Physical Therapy, P.C. Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Nola Physical Therapy, P.C. Physical Therapist Past Accepting new patients

Locations

119 W 57th St
Ste 600
New York, NY 10019
Phone (212) 974-7252

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1417137928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W 57TH ST",
            "address_2": "SUITE 212",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192303",
            "telephone_number": "212-421-1740",
            "fax_number": "212-421-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W 57TH ST",
            "address_2": "SUITE 212",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192303",
            "telephone_number": "212-421-1740",
            "fax_number": "212-421-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMOS",
        "first_name": "MARTA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029033-1",
            "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 30, 2011; 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.