Individual provider Active NPI

Shoshana Izkhakov, DPT

  • Physical Therapist
  • East Amherst, NY
National Provider Identifier
1679891857
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031939-1 Issued in NY
Practice address
6363 Transit Rd
East Amherst, NY 14051-2716
Phone
(716) 688-7880
NPI assigned
May 12, 2010
Last updated
Oct 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 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 031939-1 NY Primary

Addresses

Primary practice location

6363 Transit Rd
East Amherst, NY 14051-2716

Mailing address

20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616
Phone (631) 467-3700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170831003350 NV Practitioner - Physical Therapist in Private Practice 9436281342 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summerlin Pelvic and Physical Therapy LLCGroup PAC ID 2769716554, 3 clinicians

Practice addresses (Care Compare)

5775 S Fort Apache Rd
Suite 120
Las Vegas, NV 89148-5627
Phone (702) 331-1654

9414 Del Webb Blvd
Las Vegas, NV 89134-8314
Phone (702) 331-1654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031939-1NYMDPhysical Therapist
031939NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Hills Pelvic and Physical Therapy PLLC Physical Therapist Current Accepting new patients
Summerlin Pelvic and Physical Therapy LLC Physical Therapist CurrentSince Feb 4, 2019 Accepting new patients
Desert Orthopaedic Center, LTD. CurrentSince Aug 14, 2017 Accepting new patients
Weston Paxxon PT, OT & SLP, PLLC Physical Therapist Past Accepting new patients
Sherrie Glasser, Physical Therapist. PC Physical Therapist Past Accepting new patients

Locations

2800 E Desert Inn Rd
Ste 100
Las Vegas, NV 89121
Phone (702) 294-7499

5775 S Fort Apache Rd
Ste 120
Las Vegas, NV 89148
Phone (702) 331-1654

8402 Centennial Pkwy
Las Vegas, NV 89149
Phone (702) 869-3486

9414 Del Webb Blvd
Las Vegas, NV 89134
Phone (702) 302-1460

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1679891857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-467-3700",
            "fax_number": "631-467-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 TRANSIT RD",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140512716",
            "telephone_number": "716-688-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZKHAKOV",
        "first_name": "SHOSHANA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031939-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.