NPIMap

Organization Active NPI

Total Care Physical Therapy & Sports Medicine PC

  • Sports Physical Therapist
  • Union City, NJ
National Provider Identifier
1538535869
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
40QA01479500 Issued in NJ
Legal business name
TOTAL CARE PHYSICAL THERAPY & SPORTS MEDICINE PC
Practice address
4801 Broadway
Union City, NJ 07087-6516
Phone
(917) 362-0646
NPI assigned
Aug 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Authorized official

Name
Artur Mullokandov, PTNPI 1295002988
Title
Owner
Phone
(917) 362-0646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X 40QA01479500 NJ Primary

Addresses

Primary practice location

4801 Broadway
Union City, NJ 07087-6516

Mailing address

4801 Broadway
Union City, NJ 07087-6516

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160104001517 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3678875978 Receives reassigned benefits from 12 practitioners
Practice locations: Union City, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1538535869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 BROADWAY",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070876516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 BROADWAY",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070876516",
            "telephone_number": "917-362-0646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL CARE PHYSICAL THERAPY & SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "MULLOKANDOV",
        "authorized_official_first_name": "ARTUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-362-0646",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "NJ",
            "license": "40QA01479500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.