Organization Active NPI

Mission One Physical Therapy PLLC

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1689433641
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MISSION ONE PHYSICAL THERAPY PLLC
Practice address
856 Dekalb Ave
Brooklyn, NY 11221-1402
Phone
(551) 328-9559
NPI assigned
Mar 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Manishaben KatariyaNPI 1578277729
Title
Owner
Phone
(551) 328-9559

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 Primary

Addresses

Primary practice location

856 Dekalb Ave
Brooklyn, NY 11221-1402

Mailing address

483B Liberty Ave FL 2
Jersey City, NJ 07307-4029
Phone (551) 328-9559

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240401001578 NY Part B Supplier - Clinic/Group Practice 3274971999 Receives reassigned benefits from 2 practitioners
Practice locations: Bronx, NY; New York, NY; Howard Beach, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1689433641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483B LIBERTY AVE FL 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073074029",
            "telephone_number": "551-328-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112211402",
            "telephone_number": "551-328-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION ONE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "KATARIYA",
        "authorized_official_first_name": "MANISHABEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "551-328-9559"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.