Individual provider Active NPI

Tatyana Migdalovich, LPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1467570986
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027240 Issued in NY
Practice address
2379 65TH St
Brooklyn, NY 11204-4045
Phone
(719) 375-0392
Fax
(718) 375-4324
NPI assigned
Mar 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 027240 NY Primary

Addresses

Primary practice location

2379 65TH St
Brooklyn, NY 11204-4045

Mailing address

2379 65TH St
Brooklyn, NY 11204-4045
Phone (719) 375-0392

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070622000105 NY Practitioner - Physical Therapist in Private Practice 1153420740 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027240NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Priority One Therapy PT OT SLP PLLC CurrentSince Jun 15, 2021 Accepting new patients
Alexander Merson, M.D., PLLC Past Accepting new patients

Locations

99 W Hawthorne Ave
Ste 210
Valley Stream, NY 11580
Phone (718) 305-1190

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467570986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2379 65TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044045",
            "telephone_number": "719-375-0392",
            "fax_number": "718-375-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2379 65TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044045",
            "telephone_number": "719-375-0392",
            "fax_number": "718-375-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIGDALOVICH",
        "first_name": "TATYANA",
        "name_prefix": "Ms.",
        "credential": "LPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.