Organization Active NPI

Apollo Physical Therapy & Physical Therapist Assistant, PLLC

  • Physical Therapist
  • New York, NY
National Provider Identifier
1497974067
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23023690 Issued in NY
Legal business name
APOLLO PHYSICAL THERAPY & PHYSICAL THERAPIST ASSISTANT, PLLC
Practice address
304 W 117TH St
New York, NY 10026-1573
Phone
(917) 493-9600
Fax
(917) 493-2078
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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

Authorized official

Name
Mr. Armando C Pennella, PTA
Title
Manager
Phone
(917) 493-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 23023690 NY Primary

Addresses

Primary practice location

304 W 117TH St
New York, NY 10026-1573

Mailing address

304 W 117TH St
New York, NY 10026-1573
Phone (917) 493-9600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230321000289 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5092189795 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1497974067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W 117TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261573",
            "telephone_number": "917-493-9600",
            "fax_number": "917-493-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W 117TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261573",
            "telephone_number": "917-493-9600",
            "fax_number": "917-493-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO PHYSICAL THERAPY & PHYSICAL THERAPIST ASSISTANT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "PENNELLA",
        "authorized_official_first_name": "ARMANDO",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-493-9600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "23023690",
            "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 Jul 21, 2009; 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.