Individual provider Active NPI

Sarah Alissa Rudman, PT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1508309469
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040991-1 Issued in NY
Practice address
56 Dewhurst St
Staten Island, NY 10314-5006
Phone
(718) 377-5000
Fax
(718) 377-5002
NPI assigned
Nov 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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 040991-1 NY Primary

Addresses

Primary practice location

56 Dewhurst St
Staten Island, NY 10314-5006

Mailing address

800 E Gate Blvd
Garden City, NY 11530-2105
Phone (516) 745-8050

Other practice location 1

800 E Gate Blvd
Garden City, NY 11530-2105
Phone (516) 745-8050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040991-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1508309469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E GATE BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302105",
            "telephone_number": "516-745-8050",
            "fax_number": "516-745-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 DEWHURST ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145006",
            "telephone_number": "718-377-5000",
            "fax_number": "718-377-5002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E Gate Blvd",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "NY",
            "postal_code": "115302105",
            "country_code": "US",
            "telephone_number": "516-745-8050",
            "fax_number": "516-745-8055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDMAN",
        "first_name": "SARAH",
        "middle_name": "ALISSA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040991-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.