NPIMap

Organization Active NPI

American Edge Physical Therapy, P.C.

  • Physical Medicine & Rehabilitation Physician
  • East Meadow, NY
National Provider Identifier
1679173579
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
AMERICAN EDGE PHYSICAL THERAPY, P.C.
Practice address
1889 Lincoln Ave
East Meadow, NY 11554-2522
Phone
(516) 659-4904
NPI assigned
Oct 29, 2020
Last updated
Oct 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Authorized official

Name
Craig Yellin
Title
Manager
Phone
(516) 984-6926

Specialties & licenses 1

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

Addresses

Primary practice location

1889 Lincoln Ave
East Meadow, NY 11554-2522

Mailing address

1889 Lincoln Ave
East Meadow, NY 11554-2522
Phone (516) 659-4904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT, NJ, NC4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20210106003158 NY Part B Supplier - Clinic/Group Practice 2860805025 Receives reassigned benefits from 10 practitioners
Practice locations: East Meadow, NY
O20230424000841 CT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2860805025 Receives reassigned benefits from 1 practitioner
Practice locations: East Meadow, NY
O20230524001148 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2860805025 Receives reassigned benefits from 1 practitioner
Practice locations: East Meadow, NY
O20250908002219 NC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2860805025 Receives reassigned benefits from 1 practitioner
Practice locations: East Meadow, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1679173579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1889 LINCOLN AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542522",
            "telephone_number": "516-659-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1889 LINCOLN AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542522",
            "telephone_number": "516-659-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN EDGE PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "YELLIN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-984-6926"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.