Organization Active NPI

Kaizen Physical Therapy P.L.L.C.

  • Physical Therapy Clinic/Center
  • Poughkeepsie, NY
National Provider Identifier
1649797820
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
KAIZEN PHYSICAL THERAPY P.L.L.C.
Practice address
26 Cooper Rd Apt 715
Poughkeepsie, NY 12603
Phone
(845) 541-2230
NPI assigned
Aug 28, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Bonifacio Wenceslao Jr., PTNPI 1265798086
Title
Owner
Phone
(845) 541-2230

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

26 Cooper Rd Apt 715
Poughkeepsie, NY 12603

Mailing address

26 Cooper Rd Apt 715
Poughkeepsie, NY 12603-1670
Phone (845) 541-2230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180126002038 NY Part B Supplier - Clinic/Group Practice 2567722267 Receives reassigned benefits from 3 practitioners
Practice locations: Poughkeepsie, NY

National Provider Directory

National Provider Directory

Locations

2656 South Rd
Ste C
Poughkeepsie, NY 12601
Phone (845) 475-8299

Practitioners & affiliated clinicians

Practitioners 3

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": "1503878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1649797820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 COOPER RD APT 715",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126031670",
            "telephone_number": "845-541-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COOPER RD APT 715",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12603",
            "telephone_number": "845-541-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIZEN PHYSICAL THERAPY P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WENCESLAO",
        "authorized_official_first_name": "BONIFACIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-541-2230",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.