NPIMap

Organization Active NPI

High Line Rehab PT PC

  • Physical Therapist
  • Jackson Heights, NY
National Provider Identifier
1659756641
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
034824 Issued in NY
Legal business name
HIGH LINE REHAB PT PC
Practice address
3457 82ND St # 1G1F
Jackson Heights, NY 11372-2939
Phone
(718) 540-4740
Fax
(718) 732-2378
NPI assigned
Jul 20, 2015
Last updated
Aug 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Authorized official

Name
Nadim Elshazly, DPTNPI 1700226297
Title
Owner
Phone
(718) 540-4740

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 034824 NY Primary

Addresses

Primary practice location

3457 82ND St # 1G1F
Jackson Heights, NY 11372-2939

Mailing address

3457 82ND St # 1G1F
Jackson Heights, NY 11372-2939
Phone (718) 540-4740

Other practice location 1

148 Bay 49th St
apt 1 B
Brooklyn, NY 11214-6947
Phone (347) 926-9138

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200930000194 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6204133861 Receives reassigned benefits from 13 practitioners
Practice locations: Elmhurst, NY; Jackson Heights, NY

National Provider Directory

National Provider Directory

Locations

39 W 56th St
Apt 5
New York, NY 10019
Phone (212) 600-0220

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1659756641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3457 82ND ST # 1G1F",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113722939",
            "telephone_number": "718-540-4740",
            "fax_number": "718-732-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3457 82ND ST # 1G1F",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113722939",
            "telephone_number": "718-540-4740",
            "fax_number": "718-732-2378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "148 Bay 49th St",
            "address_2": "apt 1 B",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112146947",
            "country_code": "US",
            "telephone_number": "347-926-9138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HIGH LINE REHAB PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "ELSHAZLY",
        "authorized_official_first_name": "NADIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-540-4740",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "034824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.