Individual provider Active NPI

Carolyn S. Mazur, M.P.T., A.T.C., ART

  • Physical Therapist
  • New York, NY
National Provider Identifier
1487773719
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20721 Issued in NY
Practice address
60 Reade St
New York, NY 10007-1844
Phone
(212) 924-4920
Fax
(212) 924-0225
NPI assigned
Mar 28, 2007
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT41467 FL
Physical Therapist 225100000X 20721 NY Primary

Addresses

Primary practice location

60 Reade St
New York, NY 10007-1844

Mailing address

60 Reade St
New York, NY 10007-1844

Other practice location 1

6912 Asphalt Ave
Tampa, FL 33614-3625
Phone (813) 723-1927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060126000415 NY Practitioner - Physical Therapist in Private Practice 1153238027 Reassigns benefits to 1 organization
I20240518000166 FL Practitioner - Physical Therapist in Private Practice 1153238027 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT41467FLMDPhysical Therapist
20721NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Palm Beach Rehab, Corp Physical Therapist Current Accepting new patients
Royal Palm Beach Rehab, Corp Physical Therapist CurrentSince Apr 7, 2024 Accepting new patients
Royal Palm Beach Rehab, Corp. Physical Therapist CurrentSince Apr 7, 2024 Accepting new patients
Fusion Physical Therapy and Sports Wellness P.C. Physical Therapist CurrentSince Dec 24, 2002 Accepting new patients

Locations

4971 Le Chalet Blvd
Ste 100
Boynton Beach, FL 33436
Phone (561) 733-5590

6912 Asphalt Ave
Tampa, FL 33614
Phone (262) 488-0118

407 W 13th St
Ste 3B
New York, NY 10014
Phone (212) 924-4920

60 Reade St
New York, NY 10007
Phone (212) 924-4920

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, 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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1487773719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 READE ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100071844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 READE ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100071844",
            "telephone_number": "212-924-4920",
            "fax_number": "212-924-0225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6912 Asphalt Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336143625",
            "country_code": "US",
            "telephone_number": "813-723-1927",
            "fax_number": "813-723-1928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "CAROLYN",
        "middle_name": "S.",
        "credential": "M.P.T., A.T.C., ART",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT41467",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "20721",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 7, 2024; 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.