Individual provider Active NPI

Ewa Bhola

  • Physical Therapist
  • Copiague, NY
National Provider Identifier
1508983545
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028540 Issued in NY
Practice address
1160 Montauk Hwy
Bottom Level
Copiague, NY 11726-4904
Phone
(631) 842-4606
Fax
(631) 842-0803
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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 028540 NY Primary

Addresses

Primary practice location

1160 Montauk Hwy
Bottom Level
Copiague, NY 11726-4904

Mailing address

2142 Utopia Pkwy
Whitestone, NY 11357-4142
Phone (718) 819-6803

Other names 1

  • Ewa Zdunczyk Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110324000204 NY Practitioner - Physical Therapist in Private Practice 8820271133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Occupational and Physical Therapy, PLLC 497 clinicians

Practice addresses (Care Compare)

123 Grove Ave
Cedarhurst, NY 11516-2322
Phone (516) 374-4248

94 W Main St
Bay Shore, NY 11706-8365
Phone (631) 647-9124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028540NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients

Locations

94 W Main St
Bay Shore, NY 11706
Phone (631) 647-9124

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

1160 Montauk Hwy
Copiague, NY 11726
Phone (631) 608-0709

90 Northern Blvd
Greenvale, NY 11548
Phone (516) 626-5080

576 Broadhollow Rd
Melville, NY 11747

16 E 52nd St
Fl 6
New York, NY 10022
Phone (212) 752-2400

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 3

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1508983545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 UTOPIA PKWY",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113574142",
            "telephone_number": "718-819-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 MONTAUK HWY",
            "address_2": "BOTTOM LEVEL",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117264904",
            "telephone_number": "631-842-4606",
            "fax_number": "631-842-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHOLA",
        "first_name": "EWA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EWA",
            "last_name": "ZDUNCZYK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Copiague, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.