Individual provider Active NPI

Mohamed Abdallah

  • Physical Therapist
  • Corona, NY
National Provider Identifier
1538033006
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054227 Issued in NY
Practice address
10419 Northern Blvd
Corona, NY 11368-1134
Phone
(718) 648-0888
Fax
(855) 955-3899
NPI assigned
Sep 30, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 054227 NY Primary

Addresses

Primary practice location

10419 Northern Blvd
Corona, NY 11368-1134

Mailing address

8746 20TH Ave # L
Brooklyn, NY 11214-4802
Phone (718) 648-0888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251003003758 NY Practitioner - Physical Therapist in Private Practice 4587160809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy of the City PCGroup PAC ID 8820358484, 77 clinicians

Practice addresses (Care Compare)

10419 Northern Blvd
Corona, NY 11368-1134
Phone (718) 648-0888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054227NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy of the City PC Single Specialty CurrentSince Aug 1, 2025 Accepting new patients
Bienetre Medical PC Single Specialty CurrentSince Oct 13, 2025 Accepting new patients

Locations

3553 Johnson Ave
Bronx, NY 10463

732 Allerton Ave
Bronx, NY 10467
Phone (718) 516-0572

612 Castle Hill Ave
Bronx, NY 10473

798 Southern Blvd
Bronx, NY 10455
Phone (212) 540-5550

2488 Grand Concourse
Rm 205
Bronx, NY 10458

8403 3rd Ave
Brooklyn, NY 11209

1685 Pitkin Ave
Brooklyn, NY 11212

5418 5th Ave
Brooklyn, NY 11220
Phone (646) 752-7058

1600 Avenue M
Brooklyn, NY 11230
Phone (212) 505-5055

1230 Fulton St
Brooklyn, NY 11216
Phone (347) 604-6733

5316 Church Ave
Brooklyn, NY 11203

286 Court St
Brooklyn, NY 11231
Phone (347) 604-6733

18230 Hillside Ave
Jamaica, NY 11432

231 W 19th St
New York, NY 10011
Phone (347) 604-6733

111 Worth St
New York, NY 10013
Phone (212) 571-4621

575 8th Ave
New York, NY 10018
Phone (917) 286-4261

201 E 77th St
New York, NY 10075
Phone (212) 879-6621

4875 Broadway
New York, NY 10034

17 W 125th St
New York, NY 10027
Phone (212) 831-0200

201 E 79th St
New York, NY 10075
Phone (917) 379-9536

752 Saint Nicholas Ave
#A
New York, NY 10031

99 Hudson St
Fl 5
New York, NY 10013
Phone (646) 301-2578

1458 Lexington Ave
New York, NY 10128

Organizations & group practices 2

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": "1759190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1538033006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8746 20TH AVE # L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144802",
            "telephone_number": "718-648-0888",
            "fax_number": "855-955-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10419 NORTHERN BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681134",
            "telephone_number": "718-648-0888",
            "fax_number": "855-955-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALLAH",
        "first_name": "MOHAMED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-30",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.