Individual provider Active NPI

Mariam Eldabosy

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1538046545
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054721 Issued in NY
Practice address
3311 Shore Pkwy Apt FF
Brooklyn, NY 11235-3937
Phone
(718) 648-0888
Fax
(855) 955-3899
NPI assigned
Aug 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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 054721 NY Primary

Addresses

Primary practice location

3311 Shore Pkwy Apt FF
Brooklyn, NY 11235-3937

Mailing address

8746 20TH Ave
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
I20250827002473 NY Practitioner - Physical Therapist in Private Practice 9335640812 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
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)

3311 Shore Pkwy
Apt FF
Brooklyn, NY 11235-3937
Phone (718) 648-0888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054721NYMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Bienetre Medical PC Physical Therapist CurrentSince Jan 21, 2026 Accepting new patients
Physical Therapy of the City PC Physical Therapist CurrentSince Aug 18, 2025 Accepting new patients
Madison Physical Therapy Physical Therapist PastSince Jan 1, 2015 Accepting new patients
Scott Physical Therapy P.C. Physical Therapist Past Accepting new patients

Locations

612 Castle Hill Ave
Bronx, NY 10473

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

2488 Grand Concourse
Rm 205
Bronx, NY 10458

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

3553 Johnson Ave
Bronx, NY 10463

8403 3rd Ave
Brooklyn, NY 11209

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

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

5316 Church Ave
Brooklyn, NY 11203

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

18230 Hillside Ave
Jamaica, NY 11432

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

4875 Broadway
New York, NY 10034

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

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

752 Saint Nicholas Ave
#A
New York, NY 10031

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

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

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

1458 Lexington Ave
New York, NY 10128

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": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1538046545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8746 20TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144802",
            "telephone_number": "718-648-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 SHORE PKWY APT FF",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353937",
            "telephone_number": "718-648-0888",
            "fax_number": "855-955-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDABOSY",
        "first_name": "MARIAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.