Individual provider Active NPI

David Nonyelum Momah, PT

  • Physical Therapist
  • Bronxville, NY
National Provider Identifier
1609932474
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006102 Issued in GA
Practice address
1111 Midland Ave 1G
Bronxville, NY 10708-6337
Phone
(718) 210-6637
Fax
(678) 253-5914
NPI assigned
Dec 28, 2006
Last updated
Oct 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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 PT006102 GA Primary

Addresses

Primary practice location

1111 Midland Ave 1G
Bronxville, NY 10708-6337

Mailing address

1100 Moccasin TRL
Loganville, GA 30052-4736
Phone (770) 602-1617

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160801002320 NY Practitioner - Physical Therapist in Private Practice 3971552464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

955 Yonkers Ave
Suite B2
Yonkers, NY 10704-3062
Phone (877) 415-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
013295NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Delightful PT Services P. C. Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients
Therapeutic Maxipotent CurrentSince Mar 25, 2012 Accepting new patients
Abbanna Health & Rehab Services PC Physical Therapist PastSince Jan 26, 2006 Accepting new patients
Abbanna Health & Rehab Services P. C. Physical Therapist Past Accepting new patients

Locations

13015 Brown Bridge Rd
Ste 210
Covington, GA 30016
Phone (678) 342-6162

955 Yonkers Ave
Ste B2
Yonkers, NY 10704
Phone (877) 415-6700

Organizations & group practices 5

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1609932474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MOCCASIN TRL",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524736",
            "telephone_number": "770-602-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MIDLAND AVE 1G",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107086337",
            "telephone_number": "718-210-6637",
            "fax_number": "678-253-5914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMAH",
        "first_name": "DAVID",
        "middle_name": "NONYELUM",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronxville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.