Individual provider Active NPI

Maria Teresa Burog Ebora, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1588073878
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
35918 Issued in NY
Practice address
445 Park Ave
Brooklyn, NY 11205-2735
Phone
(718) 963-0800
Fax
(718) 534-5221
NPI assigned
Aug 12, 2014
Last updated
Jul 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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 35918 NY Primary

Addresses

Primary practice location

445 Park Ave
Brooklyn, NY 11205-2735

Mailing address

445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160622000608 NY Practitioner - Physical Therapist in Private Practice 4880985845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parcare Community Health Network IncGroup PAC ID 4981823390, 99 clinicians

Practice addresses (Care Compare)

6010 Bay Pkwy
Suite 603
Brooklyn, NY 11204-6080
Phone (718) 236-7520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35918NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Parcare Community Health Network Inc CurrentSince Mar 1, 2016 Accepting new patients
Parcare Community Health Network Inc CurrentSince Mar 1, 2016 Accepting new patients
Zhanna Roit, M.D. P.C PastSince May 23, 2016 Accepting new patients

Locations

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

6010 Bay Pkwy
Ste 603
Brooklyn, NY 11204
Phone (718) 236-7520

6010 Bay Pkwy
Ste 902
Brooklyn, NY 11204
Phone (718) 283-7500

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1588073878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 PARK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052735",
            "telephone_number": "718-963-0800",
            "fax_number": "718-534-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 PARK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052735",
            "telephone_number": "718-963-0800",
            "fax_number": "718-534-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBORA",
        "first_name": "MARIA TERESA",
        "middle_name": "BUROG",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "35918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.