NPIMap

Organization Active NPI

Energize Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Elmhurst, NY
National Provider Identifier
1427416668
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ENERGIZE PHYSICAL THERAPY PLLC
Practice address
5205 Van Loon St
Elmhurst, NY 11373-4258
Phone
(855) 856-7885
NPI assigned
Feb 2, 2016
Last updated
Mar 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Authorized official

Name
Celia Mak, DPTNPI 1265862650
Title
Physical Therapist
Phone
(347) 738-3317

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 Primary

Addresses

Primary practice location

5205 Van Loon St
Elmhurst, NY 11373-4258

Mailing address

4636 Utopia Pkwy
Flushing, NY 11358-3835
Phone (347) 738-3317

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160418000686 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0143528638 Receives reassigned benefits from 5 practitioners
Practice locations: Elmhurst, NY; Flushing, NY

National Provider Directory

National Provider Directory

Locations

5205 Van Loon St
Elmhurst, NY 11373
Phone (347) 220-8195

13630 Maple Ave
Ste 2
Flushing, NY 11355

13630 Maple Ave
Ste I
Flushing, NY 11355

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1427416668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4636 UTOPIA PKWY",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583835",
            "telephone_number": "347-738-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 VAN LOON ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734258",
            "telephone_number": "855-856-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERGIZE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "MAK",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "347-738-3317",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.