Organization Active NPI

Kinesioworks Physical Therapy, P.C.

  • Physical Therapist
  • New York, NY
National Provider Identifier
1487110888
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KINESIOWORKS PHYSICAL THERAPY, P.C.
Practice address
1980 Amsterdam Ave # 1B
New York, NY 10032-5058
Phone
(212) 740-2049
Fax
(917) 388-3417
NPI assigned
Feb 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Dr. Hazel Marucut Sto Tomas, PT, DPT
Title
Doctor of Physical Therapy
Phone
(718) 839-3046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1980 Amsterdam Ave # 1B
New York, NY 10032-5058

Mailing address

38 Deerfield St
Bergenfield, NJ 07621-1805
Phone (201) 968-6112

Other practice location 1

435 Fort Washington Ave
New York, NY 10033-3506
Phone (718) 839-3046

Other practice location 2

171 Madison Ave Rm 1000
New York, NY 10016-5121
Phone (718) 839-3046

Other identifiers 1

IdentifierTypeStateIssuer
05357539MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190418000792 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9739420894 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

1980 Amsterdam Ave
#1B
New York, NY 10032
Phone (212) 740-2049

Practitioners & affiliated clinicians

Practitioners 4

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": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1487110888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 DEERFIELD ST",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211805",
            "telephone_number": "201-968-6112",
            "fax_number": "201-561-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 AMSTERDAM AVE # 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100325058",
            "telephone_number": "212-740-2049",
            "fax_number": "917-388-3417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Fort Washington Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100333506",
            "country_code": "US",
            "telephone_number": "718-839-3046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "171 Madison Ave Rm 1000",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100165121",
            "country_code": "US",
            "telephone_number": "718-839-3046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINESIOWORKS PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-11",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "STO TOMAS",
        "authorized_official_first_name": "HAZEL",
        "authorized_official_middle_name": "MARUCUT",
        "authorized_official_title_or_position": "DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "718-839-3046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05357539",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "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 Feb 18, 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.