NPIMap

Organization Active NPI

Beacon Physical Therapy PC

  • Physical Medicine & Rehabilitation Physician
  • Staten Island, NY
National Provider Identifier
1619512316
Registry record updated Nov 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
BEACON PHYSICAL THERAPY PC
Practice address
16 Beacon Ave
Staten Island, NY 10306-1351
Phone
(212) 810-1881
NPI assigned
Nov 17, 2019
Last updated
Nov 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. George L Medrano, PTNPI 1447355250
Title
Owner
Phone
(212) 810-1881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

16 Beacon Ave
Staten Island, NY 10306-1351

Mailing address

16 Beacon Ave
Staten Island, NY 10306-1351
Phone (212) 810-1881

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573948800000",
    "number": "1619512316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BEACON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103061351",
            "telephone_number": "212-810-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BEACON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103061351",
            "telephone_number": "212-810-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-17",
        "last_updated": "2019-11-17",
        "status": "A",
        "authorized_official_last_name": "MEDRANO",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-810-1881",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.