NPIMap

Organization Active NPI

North Shore PT of Ny PC

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1437408002
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
016009-1 Issued in NY
Legal business name
NORTH SHORE PT OF NY PC
Practice address
4870 Hylan Blvd
Staten Island, NY 10312-6322
Phone
(917) 538-6692
Fax
(718) 720-3895
NPI assigned
Aug 29, 2012
Last updated
Feb 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Authorized official

Name
Dr. Hammouda Mahmoud Soliman, PTNPI 1578731196
Title
PT
Phone
(917) 538-6692

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 016009-1 NY Primary

Addresses

Primary practice location

4870 Hylan Blvd
Staten Island, NY 10312-6322

Mailing address

115 Overlook Ter
Staten Island, NY 10305-2715
Phone (917) 538-6692

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121001000404 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3072762343 Receives reassigned benefits from 5 practitioners
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory
Tax ID family
North Shore PT of Ny PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1437408002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 OVERLOOK TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052715",
            "telephone_number": "917-538-6692",
            "fax_number": "718-720-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4870 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126322",
            "telephone_number": "917-538-6692",
            "fax_number": "718-720-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE PT OF NY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "SOLIMAN",
        "authorized_official_first_name": "HAMMOUDA",
        "authorized_official_middle_name": "MAHMOUD",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "917-538-6692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016009-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.