Individual provider Active NPI

Adolph B. Meyer, MD

  • Physical Medicine & Rehabilitation Physician
  • Staten Island, NY
National Provider Identifier
1639194996
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
198050 Issued in NY
Practice address
2460 Victory Blvd
Staten Island, NY 10314-6612
Phone
(718) 966-7940
Fax
(718) 966-4382
NPI assigned
Jul 13, 2006
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 198050 NY Primary

Addresses

Primary practice location

2460 Victory Blvd
Staten Island, NY 10314-6612

Mailing address

2460 Victory Blvd
Staten Island, NY 10314-6612
Phone (718) 966-7940

Other practice location 1

3993 Richmond Ave
Staten Island, NY 10312-5112
Phone (718) 966-7940

Other practice location 2

176 Wilson Ave
Brooklyn, NY 11237-4158
Phone (718) 484-8960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090223000009 NY Practitioner - Physical Medicine and Rehabilitation 9638271224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

321 Edison St
Staten Island, NY 10306-3023
Phone (718) 966-7940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
198050NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Staten Island Medical Rehabilitation, P.C. Physical Medicine & Rehabilitation CurrentSince Sep 7, 2004 Accepting new patients
Pain Management & Rehabilitative Physical Medicine, PC Physical Medicine & Rehabilitation Past Accepting new patients
Gravesend Medical Services,P.C. PastSince Sep 6, 2006 Accepting new patients

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1639194996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146612",
            "telephone_number": "718-966-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146612",
            "telephone_number": "718-966-7940",
            "fax_number": "718-966-4382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3993 Richmond Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103125112",
            "country_code": "US",
            "telephone_number": "718-966-7940",
            "fax_number": "718-966-4382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "176 Wilson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112374158",
            "country_code": "US",
            "telephone_number": "718-484-8960",
            "fax_number": "718-484-8960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYER",
        "first_name": "ADOLPH",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "198050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.