JC Green Physical Therapy, PLLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

JC GREEN PHYSICAL THERAPY, PLLC

Practice address

4 W 101St St Apt 65
New York, NY 10025-4716

Phone

(917) 648-1949

NPI assigned

Feb 20, 2023

Organization subpart

No

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

Authorized official

Name

Jesse Green, PT, DPT, LMT, CSCS

Title

Owner/Employee

Phone

(917) 648-1949

Specialties & licenses 1

Addresses

Other names 1

• Green Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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

• Jesse Green, PT, DPT, LMT, CSCS

  • Physical Therapist
  • New York, NY
  • NPI 1447791397
  Medicare reassignment NPD

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1508564550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 W 101ST ST APT 65",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100254716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W 101ST ST APT 65",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100254716",
            "telephone_number": "917-648-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JC GREEN PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "GREEN, PT, DPT, LMT, CSCS",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "OWNER/EMPLOYEE",
        "authorized_official_telephone_number": "917-648-1949"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Green Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in New York, NY
• Providers in New York, NY by specialty
• Home Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.