Organization Active NPI

Northeast Physical Therapy PLLC

  • Orthopedic Physical Therapist
  • Pearl River, NY
National Provider Identifier
1467112854
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
NORTHEAST PHYSICAL THERAPY PLLC
Practice address
275 N Middletown Rd Ste 1B
Pearl River, NY 10965-1191
Phone
(845) 623-6566
Fax
(845) 623-6556
NPI assigned
Dec 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Authorized official

Name
Sudhir V Tawalare, PTNPI 1871529701
Title
Owner
Phone
(845) 623-6566

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251H1200X
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

275 N Middletown Rd Ste 1B
Pearl River, NY 10965-1191

Mailing address

281 Spring Valley Rd
Park Ridge, NJ 07656-1017
Phone (845) 623-6566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230109000406 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6608246657 Receives reassigned benefits from 2 practitioners
Practice locations: Pearl River, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1467112854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 SPRING VALLEY RD",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561017",
            "telephone_number": "845-623-6566",
            "fax_number": "845-623-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 N MIDDLETOWN RD STE 1B",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651191",
            "telephone_number": "845-623-6566",
            "fax_number": "845-623-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-27",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "TAWALARE",
        "authorized_official_first_name": "SUDHIR",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-623-6566",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251H1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.