Organization Active NPI

Rockaway Park Physical Therapy PLLC

  • Physical Therapist
  • Rockaway Park, NY
National Provider Identifier
1508132804
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032431 Issued in NY
Legal business name
ROCKAWAY PARK PHYSICAL THERAPY PLLC
Practice address
10322 Rockaway Beach Blvd
Rockaway Park, NY 11694-2739
Phone
(718) 318-8550
NPI assigned
Mar 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
Yehuda Litvintchouk, DPTNPI 1235452020
Title
Ceo
Phone
(718) 318-8550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 032431 NY Primary

Addresses

Primary practice location

10322 Rockaway Beach Blvd
Rockaway Park, NY 11694-2739

Mailing address

10322 Rockaway Beach Blvd
Rockaway Park, NY 11694-2739
Phone (718) 318-8550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120716000297 NY Part B Supplier - Clinic/Group Practice 6507022712 Receives reassigned benefits from 2 practitioners
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

6805 Main St
Flushing, NY 11367
Phone (718) 263-2606

Practitioners & affiliated clinicians

Practitioners 8

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": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1508132804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10322 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942739",
            "telephone_number": "718-318-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10322 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942739",
            "telephone_number": "718-318-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKAWAY PARK PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "LITVINTCHOUK",
        "authorized_official_first_name": "YEHUDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-318-8550",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockaway Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.