Lifespire, Inc.
Organization Active NPI Clinic/Center · New York, NY
NPI 1497709166 · NPPES record last updated Aug 31, 2026
Key facts
- NPI
- 1497709166
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- LIFESPIRE, INC.
- Practice address
- 159 E 125TH St
New York, NY 10035-1748 - Phone
- (212) 828-8506
- Fax
- (212) 876-8942
- NPI assigned
- May 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Emilio Bonilla
- Title
- Cfo
- Phone
- (212) 741-0100
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 3
Practitioners 130
-
Akintayo Olalekan Fadoju, RN, NP
-
Deborah Joyce Marsh, MA,CCC,SLP
-
Aderemi Isola Adeyemi, P.T.
-
James Antoine, DPT
-
Jeanette Buss, PT
-
Valcuse Delma, SLP
-
Lisa M Doce, LCSW-R
-
Micah Galen Duchan, PSY.D.
-
Marianne Terrado Estira, P.T.
-
Alan Mitchell Fisher, OTR
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040312000104 | NY | Part B Supplier - Clinic/Group Practice | 5496644015 |
Receives reassigned benefits from 49 practitioners 1 other NPI on this enrollment Practice locations: Bayside, NY; Staten Island, NY; Richmond Hill, NY; New York, NY; Jamaica, NY; Brooklyn, NY; Bronx, NY |
National Provider Directory
- Tax ID family
- North Shore-Lij Medical PC
Locations
21301 Northern Blvd
Fl 2
Bayside, NY 11361
Phone (718) 721-5444
2435 Harway Ave
Brooklyn, NY 11214
Phone (212) 741-0100
16210 Jamaica Ave
Ste 7
Jamaica, NY 11432
Phone (718) 454-2700
350 5th Ave
Ste 301
New York, NY 10118
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | NY | Yes |
Addresses
Primary practice location
159 E 125TH St
New York, NY 10035-1748
Mailing address
462 Fashion Ave FL 5
New York, NY 10018-7852
Phone (212) 741-0100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01500150 | Medicaid | NY | |
| 00347755 | Medicaid | NY |
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2026. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.