Individual provider Active NPI

Randolph Bendo, PT

  • Physical Therapist
  • Elmhurst, NY
National Provider Identifier
1679858740
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032724 Issued in NY
Practice address
8202 Grand Ave
Suite 1a
Elmhurst, NY 11373-4133
Phone
(718) 606-0849
Fax
(718) 606-1077
NPI assigned
Oct 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 032724 NY Primary

Addresses

Primary practice location

8202 Grand Ave
Suite 1a
Elmhurst, NY 11373-4133

Mailing address

8202 Grand Ave
Suite 1a
Elmhurst, NY 11373-4133
Phone (718) 606-0849

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000732 NY Practitioner - Physical Therapist in Private Practice 6002074663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1763 Dutch Broadway
Elmont, NY 11003-5044
Phone (516) 812-6145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
032724NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Island Musculoskeletal Care MD PC Physical Therapist Current Accepting new patients
Island Musculoskeletal Care MD PC Physical Therapist CurrentSince Oct 29, 2011 Accepting new patients
Island Musculoskeletal Care MD PC Physical Therapist CurrentSince Oct 29, 2011 Accepting new patients
Spark Physical Therapy PLLC Physical Therapist CurrentSince Nov 4, 2022 Accepting new patients
Woodhaven Physical Therapy & Rehab Services PLLC Physical Therapist Past Accepting new patients
Mamaroneck Physical Therapy PC Physical Therapist Past Accepting new patients

Locations

1763 Dutch Broadway
Elmont, NY 11003
Phone (347) 656-4109

1763 Dutch Broadway
#1765
Elmont, NY 11003
Phone (516) 812-6145

13616 35th Ave
Ste 1B
Flushing, NY 11354
Phone (718) 939-8600

125 Franklin Ave
Valley Stream, NY 11580
Phone (516) 825-7000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1679858740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8202 GRAND AVE",
            "address_2": "SUITE 1A",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734133",
            "telephone_number": "718-606-0849",
            "fax_number": "718-606-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 GRAND AVE",
            "address_2": "SUITE 1A",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734133",
            "telephone_number": "718-606-0849",
            "fax_number": "718-606-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDO",
        "first_name": "RANDOLPH",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.