Individual provider Active NPI

Rebecca Lynn Gonzalez, PT, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1508563545
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1995 Broadway FL 15
New York, NY 10023-5882
Phone
(212) 712-2006
NPI assigned
Feb 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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 NY Primary

Addresses

Primary practice location

1995 Broadway FL 15
New York, NY 10023-5882

Mailing address

4110 Bowne St Apt 2V
Flushing, NY 11355-5601
Phone (347) 633-1614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230921000832 NY Practitioner - Physical Therapist in Private Practice 6204280589 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stroma Physical Therapy LLCGroup PAC ID 8123204401, 11 clinicians

Practice addresses (Care Compare)

152 W 25TH St
Suite 601
New York, NY 10001-7480
Phone (212) 255-5531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
S2 Physical Therapy P.C. Physical Therapist CurrentSince Sep 7, 2023 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Nov 25, 2024 Accepting new patients
Stroma Physical Therapy LLC Physical Therapist CurrentSince Feb 17, 2025 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Nov 25, 2024 Accepting new patients

Locations

550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737

1 Bridge St
Ste 71
Irvington, NY 10533
Phone (914) 375-3434

152 W 25th St
Rm 601
New York, NY 10001
Phone (212) 255-5531

1995 Broadway
Fl 15
New York, NY 10023
Phone (212) 712-2006

159 E 74th St
Unit 3
New York, NY 10021
Phone (466) 762-4414

Organizations & group practices 4

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": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1508563545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 BOWNE ST APT 2V",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555601",
            "telephone_number": "347-633-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 BROADWAY FL 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235882",
            "telephone_number": "212-712-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "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 Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.