Individual provider Active NPI

Elizabeth S Opoka, PT, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1558908459
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
036526-1 Issued in NY
Practice address
113 W 78TH St
New York, NY 10024-6755
Phone
(212) 579-2858
NPI assigned
Dec 10, 2019
Last updated
Dec 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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 036526-1 NY Primary

Addresses

Primary practice location

113 W 78TH St
New York, NY 10024-6755

Mailing address

433 7TH Ave Apt 4
Brooklyn, NY 11215-7310
Phone (917) 586-3894

Other names 1

  • Dr. Liz S Opoka Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230329001597 NY Practitioner - Physical Therapist in Private Practice 9133593346 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036526-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Living Well Balanced Nyc Medical PLLC CurrentSince Jan 30, 2024 Accepting new patients
Well Balanced Chiropractic PC CurrentSince Dec 15, 2019 Accepting new patients

Locations

180 W 80th St
New York, NY 10024
Phone (212) 579-2858

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1558908459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 7TH AVE APT 4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112157310",
            "telephone_number": "917-586-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W 78TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246755",
            "telephone_number": "212-579-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPOKA",
        "first_name": "ELIZABETH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-10",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036526-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIZ",
            "last_name": "OPOKA",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "PT, DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.