NPIMap

Organization Active NPI

Elite Care Physical Therapy Rehab.P.C.

  • Physical Therapist
  • New York, NY
National Provider Identifier
1679780654
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
005975-1 Issued in NY
Legal business name
ELITE CARE PHYSICAL THERAPY REHAB.P.C.
Practice address
630 Fort Washington Ave
New York, NY 10040-3900
Phone
(212) 927-3422
Fax
(212) 927-9250
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Authorized official

Name
Mrs. Renee Fishweicher, PTMSNPI 1750383147
Title
Director
Phone
(212) 927-3422

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 005975-1 NY Primary

Addresses

Primary practice location

630 Fort Washington Ave
New York, NY 10040-3900

Mailing address

630 Fort Washington Ave
New York, NY 10040-3900
Phone (212) 927-3422

Other identifiers 4

IdentifierTypeStateIssuer
1891709770OtherNYINDIVIDUAL NPI NUMBER
10764994OtherNYINDIVIDUAL CAQH NUMBER
1750383147OtherNYINDIVIDUAL NPI NUMBER
1801017587OtherNYINDIVIDUAL NPI NUMBER

Other names 1

  • elite care rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080304000629 NY Part B Supplier - Clinic/Group Practice 6103716733 Receives reassigned benefits from 4 practitioners
Practice locations: New York, 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.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1679780654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100403900",
            "telephone_number": "212-927-3422",
            "fax_number": "212-927-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100403900",
            "telephone_number": "212-927-3422",
            "fax_number": "212-927-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CARE PHYSICAL THERAPY REHAB.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "FISHWEICHER",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "212-927-3422",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PTMS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "005975-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1891709770",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL CAQH NUMBER",
            "identifier": "10764994",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1750383147",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1801017587",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "elite care rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.