David Nonyelum Momah, PT
Individual provider Active NPI Physical Therapist · Bronxville, NY
NPI 1609932474 · NPPES record last updated Oct 6, 2015
Key facts
- NPI
- 1609932474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT006102 (GA)
- Practice address
- 1111 Midland Ave 1G
Bronxville, NY 10708-6337 - Phone
- (718) 210-6637
- Fax
- (678) 253-5914
- NPI assigned
- Dec 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160801002320 | NY | Practitioner - Physical Therapist in Private Practice | 3971552464 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013295 | NY | MD | Chiropractor |
| PT006102 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Maxipotent | Current |
Accepting new patients | |
| Delightful PT Services P. C. | Physical Therapist | Current |
Accepting new patients |
| Abbanna Health & Rehab Services P. C. | Physical Therapist | Past | Accepting new patients |
| Abbanna Health & Rehab Services PC | 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT006102 | GA | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 825334443A | Medicaid | GA |
Other providers in Bronxville, NY
- Ayesha Fahad Mir
- Saeid Mirafzali
- Lauren Mizak
- ML Gastroenterology PLLC
- Brandon Scott Mogrovejo
- Dayana Morales
- Rebecca Morales
- Trisha E Moricette
- Kim Morrison
- Dyness Moshi
All providers in Bronxville, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.