Eloisa Lara, PT
Individual provider Active NPI Physical Therapist · Montebello, NY
NPI 1487320396 · NPPES record last updated Aug 19, 2021
Key facts
- NPI
- 1487320396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 047411-01 (NY)
- Practice address
- 28B Indian Rock
Montebello, NY 10901-4907 - Phone
- (845) 368-2180
- Fax
- (845) 368-2187
- NPI assigned
- Aug 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 17
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Montefiore Medical Center
Practice addresses (Care Compare)
111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255
14 Orangetown Shopping Ctr
Orangeburg, NY 10962-2143
Phone (845) 580-4100
28 B Indian Rock
Montebello, NY 10901-4907
Phone (845) 368-2180
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210920000851 | NY | Practitioner - Physical Therapist in Private Practice | 1456758424 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047411-01 | NY | MD | Physical Therapist |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current |
Accepting new patients | |
| Montefiore Medical Center | Current |
Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
30 Indian Rock
Ste 3
Suffern, NY 10901
Phone (845) 368-2108
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 047411-01 | NY | Yes |
Addresses
Primary practice location
28B Indian Rock
Montebello, NY 10901-4907
Mailing address
25 Crest St Apt 117
Westwood, NJ 07675-3169
Phone (201) 449-4779
Other providers in Montebello, NY
- Martha Kimmel
- Michael Charles Kirshner
- Robert Klotz
- Vicki H Korman
- Language Links
- Elka Lipszyc
- Talia Lipton
- Louis-Jacques Health, LLC
- Karolina M Lupinska-Mogila
- Christine Leslie Macnaughton
All providers in Montebello, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.