Individual provider Active NPI

James A Nussbaum, PHD, MSPT, CSCS, EMT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1588682686
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
020992 Issued in NY
Practice address
180 W End Ave
Suite # 1M
New York, NY 10023-4902
Phone
(212) 600-4781
Fax
(800) 655-3780
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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 020992 NY Primary

Addresses

Primary practice location

180 W End Ave
Suite # 1M
New York, NY 10023-4902

Mailing address

180 W End Ave
Suite # 1M
New York, NY 10023-4902
Phone (212) 600-4781

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041119000627 NY Practitioner - Physical Therapist in Private Practice 3870558786 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth and Fitness PT OT PLLCGroup PAC ID 4284828757, 10 clinicians

Practice addresses (Care Compare)

180 W End Ave
Apt 1M
New York, NY 10023-4917
Phone (212) 600-4781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Emergency Medical Technician, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
020992NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth and Fitness PT OT PLLC Physical Therapist CurrentSince May 1, 2010 Accepting new patients
Prohealth and Fitness PT OT PLLC Physical Therapist CurrentSince May 1, 2010 Accepting new patients
Emusc, LLC CurrentSince Mar 27, 2024 Accepting new patients
Prohealth & Fitness Past Accepting new patients

Locations

8340 Woodhaven Blvd
Glendale, NY 11385
Phone (718) 441-0101

12046 Queens Blvd
Kew Gardens, NY 11415
Phone (718) 793-3341

150 W End Ave
Apt 1M
New York, NY 10023
Phone (212) 496-2600

1041 3rd Ave
Ofc 2
New York, NY 10065
Phone (212) 362-3470

Networks

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

Organizations & group practices 7

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1588682686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 W END AVE",
            "address_2": "SUITE # 1M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234902",
            "telephone_number": "212-600-4781",
            "fax_number": "800-655-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W END AVE",
            "address_2": "SUITE # 1M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234902",
            "telephone_number": "212-600-4781",
            "fax_number": "800-655-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD, MSPT, CSCS, EMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020992",
            "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 Jan 31, 2008; 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.