Pro Care Physical Therapy Group PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

025676 Issued in NY

Legal business name

PRO CARE PHYSICAL THERAPY GROUP PC

Practice address

4111 30TH Ave Ste C
Astoria, NY 11103-2913

Phone

(718) 274-4400

NPI assigned

Mar 2, 2009

Last updated

Mar 2, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mauricio Mark Clemente Zamora, RPTNPI 1457317315

Title

Physical Therapist

Phone

(917) 774-1436

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, and the practitioner matching its NPPES authorized official.

• Mauricio Mark Clemente Zamora, RPT

  • Physical Therapist
  • Flushing, NY
  • NPI 1457317315
  Medicare reassignment NPD Authorized official
• Alexander De Jesus, PT

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1912046541
  NPD (past)

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1437399532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 30TH AVE STE C",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111032913",
            "telephone_number": "718-274-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 30TH AVE STE C",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111032913",
            "telephone_number": "718-274-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO CARE PHYSICAL THERAPY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-02",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "MAURICIO MARK",
        "authorized_official_middle_name": "CLEMENTE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "917-774-1436",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "025676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/GHI",
            "identifier": "04255Q",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prevail Physical Therapy, LLC
• Maricela Prieto
• Prime One Medical Services PLLC
• Prime Optics LLC
• Prime Well Pharmacy Inc.
• Vanessa Elizabeth Proano Ron
• Procare Services Inc,
• Professional Dental Associates PC
• Prohealth Care Associates, LLP
• Prohealth Dental PLLC (Astoria Orthodontia)

• Physical Therapy Clinic/Center in Astoria, NY
• Providers in Astoria, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.