Organization Active NPI

Physiocare Physical Therapy of New York PLLC

  • Rehabilitation Practitioner
  • New York, NY
National Provider Identifier
1477200970
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Legal business name
PHYSIOCARE PHYSICAL THERAPY OF NEW YORK PLLC
Practice address
185 Canal St Ste 505
New York, NY 10013-4537
Phone
(917) 502-0736
NPI assigned
Mar 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Authorized official

Name
Jennifer EstrellaNPI 1619257276
Title
Clinical Director
Phone
(917) 502-0736

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
Rehabilitation PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 225400000X Primary

Addresses

Primary practice location

185 Canal St Ste 505
New York, NY 10013-4537

Mailing address

642 Emerson Dr
West Hempstead, NY 11552-3923

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL physiocareptny@gmail.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220728002146 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1759769045 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

185 Canal St
Ste 505
New York, NY 10013
Phone (212) 966-3040

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": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1477200970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 EMERSON DR",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115523923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 CANAL ST STE 505",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134537",
            "telephone_number": "917-502-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOCARE PHYSICAL THERAPY OF NEW YORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "ESTRELLA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "917-502-0736"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "physiocareptny@gmail.com",
            "affiliation": "N",
            "address_1": "185 Canal St Ste 505",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100134537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.