Individual provider Active NPI

Mariam Kodsy

  • Orthopedic Physical Therapist
  • New York, NY
National Provider Identifier
1578114336
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
043204 Issued in NY
Practice address
130 W 42ND St Ste 1055
New York, NY 10036-7901
Phone
(212) 308-9595
NPI assigned
Sep 24, 2019
Last updated
Sep 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 043204 NY Primary

Addresses

Primary practice location

130 W 42ND St Ste 1055
New York, NY 10036-7901

Mailing address

124 W 60TH St
New York, NY 10023-7451
Phone (929) 215-8812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
043204NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Medical Care PC CurrentSince Sep 29, 2019 Accepting new patients

Locations

130 W 42nd St
Ste 1055
New York, NY 10036
Phone (212) 308-9595

Organizations & group practices 1

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": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1578114336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W 60TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237451",
            "telephone_number": "929-215-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W 42ND ST STE 1055",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100367901",
            "telephone_number": "212-308-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODSY",
        "first_name": "MARIAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "043204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.