Individual provider Active NPI

Adham Zidan

  • Geriatric Physical Therapist
  • North Tonawanda, NY
National Provider Identifier
1497548838
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
Practice address
356 Bennett St
North Tonawanda, NY 14120-4102
Phone
(716) 550-9697
NPI assigned
May 28, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X Primary

Addresses

Primary practice location

356 Bennett St
North Tonawanda, NY 14120-4102

Mailing address

356 Bennett St
North Tonawanda, NY 14120-4102

Other practice location 1

356 Bennett St
North Tonawanda, NY 14120-4102
Phone (716) 550-9697

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250703003805 NY Practitioner - Physical Therapist in Private Practice 0143734970 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stern at Home Physical Therapy PC Geriatrics CurrentSince Jun 26, 2025 Accepting new patients

Locations

4 Medical Park Dr
Ste B
Pomona, NY 10970
Phone (845) 354-3131

Organizations & group practices 1

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": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1497548838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 BENNETT ST",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 BENNETT ST",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204102",
            "telephone_number": "716-550-9697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "356 Bennett St",
            "address_purpose": "LOCATION",
            "city": "North Tonawanda",
            "state": "NY",
            "postal_code": "141204102",
            "country_code": "US",
            "telephone_number": "716-550-9697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIDAN",
        "first_name": "ADHAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.