Active NPI
St Maurice Physical Therapy PC
- Physical Therapist
- Westbury, NY
National Provider Identifier
1588017677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 033723
- Legal business name
- ST MAURICE PHYSICAL THERAPY PC
- Practice address
- 899 Bowling Green Dr
Westbury, NY 11590-6103 - Phone
- (347) 656-6998
- NPI assigned
- Jul 13, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Micheal Bakhom, DPT
- Title
- Agent
- Phone
- (347) 656-6998
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 033723 | NY | Primary |
Addresses
Primary practice location
899 Bowling Green Dr
Westbury, NY 11590-6103
Mailing address
899 Bowling Green Dr
Westbury, NY 11590-6103
Phone (347) 656-6998
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
182 S Main St
#109
New City, NY 10956
500 Todt Hill Rd
Staten Island, NY 10304
Phone (330) 550-0258
Practitioners & affiliated clinicians
Practitioners 6
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.
-
- Physical Therapist
- Westbury, NY
- NPI 1558791426
-
- Physical Therapist
- Deer Park, NY
- NPI 1104226794
-
- Physical Therapist
- Westbury, NY
- NPI 1922401538
-
- Physical Therapist
- Forest Hills, NY
- NPI 1609309962
-
- Physical Therapist
- Ridgewood, NY
- NPI 1396605135
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468368000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1468800000000",
"number": "1588017677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "899 BOWLING GREEN DR",
"city": "WESTBURY",
"state": "NY",
"postal_code": "115906103",
"telephone_number": "347-656-6998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "899 BOWLING GREEN DR",
"city": "WESTBURY",
"state": "NY",
"postal_code": "115906103",
"telephone_number": "347-656-6998"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST MAURICE PHYSICAL THERAPY PC",
"organizational_subpart": "NO",
"enumeration_date": "2016-07-13",
"last_updated": "2016-07-18",
"status": "A",
"authorized_official_last_name": "BAKHOM",
"authorized_official_first_name": "MICHEAL",
"authorized_official_title_or_position": "AGENT",
"authorized_official_telephone_number": "347-656-6998",
"authorized_official_credential": "DPT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "NY",
"license": "033723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Westbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.