Omega Physical Therapy,PC

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

020632 Issued in NY

Legal business name

OMEGA PHYSICAL THERAPY,PC

Practice address

2327 83Rd St Ste C
Brooklyn, NY 11214-2749

Phone

(718) 996-9929

Fax

(718) 265-1807

NPI assigned

May 20, 2009

Last updated

Feb 16, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dmitry Shestakovsky, DPTNPI 1467502922

Title

President

Phone

(718) 996-9929

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dmitry Shestakovsky, DPT

  • Orthopedic Physical Therapist
  • Brooklyn, NY
  • NPI 1467502922
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1578798534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2327 83RD ST STE C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112142749",
            "telephone_number": "718-996-9929",
            "fax_number": "718-265-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 83RD ST STE C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112142749",
            "telephone_number": "718-996-9929",
            "fax_number": "718-265-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA PHYSICAL THERAPY,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "SHESTAKOVSKY",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-996-9929",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NY",
            "license": "020632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ome Drug Corp (Fine Care Pharmacy)
• Teri-Ann Micha Omeally
• Omega Augustus-Barro
• Omega Diagnostic Imaging, P.C.
• Omega Kids Inc.
• Alina Omelkina, COTA
• Omer Corp.
• Omer Tipu Physician PC
• Toba Olushola Omidiji, NP
• Mohammadmehdi Omidvari, M.D.

• Physical Disabilities Residential Treatment Facility in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Disabilities Residential Treatment Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.