Individual provider Active NPI

Alexei Vitrak

  • Physical Therapist
  • Tarrytown, NY
National Provider Identifier
1487323762
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047591 Issued in NY
Practice address
155 White Plains Rd FL East
Tarrytown, NY 10591-5523
Phone
(914) 333-2404
NPI assigned
Sep 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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 047591 NY Primary

Addresses

Primary practice location

155 White Plains Rd FL East
Tarrytown, NY 10591-5523

Mailing address

65 Madison St Apt 4
Newark, NJ 07105-2347
Phone (646) 659-9346

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211216001396 NY Practitioner - Physical Therapist in Private Practice 7214328707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, 2,262 clinicians

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047591NYMDPharmacist

Practice roles (4 of 8)

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Sep 17, 2021 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 17, 2021 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

51 Audubon Ave
Fl 1
New York, NY 10032
Phone (212) 304-5794

155 White Plains Rd
Fl E
Tarrytown, NY 10591
Phone (914) 333-2404

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1487323762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MADISON ST APT 4",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071052347",
            "telephone_number": "646-659-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WHITE PLAINS RD FL EAST",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915523",
            "telephone_number": "914-333-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITRAK",
        "first_name": "ALEXEI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-09",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarrytown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.