Individual provider Active NPI

Kery Mota, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1497764807
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
521 5TH Ave
C/O Eqiunox Fitness Club
New York, NY 10175-0003
Phone
(212) 692-9558
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 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 Primary

Addresses

Primary practice location

521 5TH Ave
C/O Eqiunox Fitness Club
New York, NY 10175-0003

Mailing address

66 Louisa St # 1F
Brooklyn, NY 11218-3012
Phone (978) 884-4830

Other identifiers 1

IdentifierTypeStateIssuer
006270-1OtherNYLICSENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410002461 NY Practitioner - Physical Therapist in Private Practice 4385082296 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Priority One Therapy PT OT SLP PLLC CurrentSince Mar 3, 2024 Accepting new patients

Locations

99 W Hawthorne Ave
Ste 210
Valley Stream, NY 11580
Phone (718) 305-1190

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1497764807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 LOUISA ST # 1F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183012",
            "telephone_number": "978-884-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 5TH AVE",
            "address_2": "C/O EQIUNOX FITNESS CLUB",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101750003",
            "telephone_number": "212-692-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTA",
        "first_name": "KERY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSENSE NUMBER",
            "identifier": "006270-1",
            "state": "NY"
        }
    ],
    "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 Apr 16, 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.