Individual provider Active NPI

Ayman Mohamed Elattar, P.T.

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1689960080
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014036-1 Issued in NY
Practice address
406 15TH St.
Suite M1A
Brooklyn, NY 11215
Phone
(718) 369-7560
Fax
(718) 369-7563
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 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 014036-1 NY Primary

Addresses

Primary practice location

406 15TH St.
Suite M1A
Brooklyn, NY 11215

Mailing address

46 Rowan Ave
Staten Island, NY 10306
Phone (718) 979-2928

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111216000114 NY Practitioner - Physical Therapist in Private Practice 6103091350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore PT of Ny PCGroup PAC ID 3072762343, 2 clinicians

Practice addresses (Care Compare)

801 Narrows Rd N
Staten Island, NY 10304-1500
Phone (917) 538-6692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014036-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore PT of Ny PC Physical Therapist CurrentSince May 1, 2024 Accepting new patients
Edison Medical PC Past Accepting new patients
Hartford Medical PC Past Accepting new patients
North Shore PT of Ny PC Physical Therapist Past Accepting new patients
Hader Physical Therapy PC Physical Therapist Past Accepting new patients

Locations

801 Narrows Rd N
Staten Island, NY 10304
Phone (718) 727-8498

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1689960080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 ROWAN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10306",
            "telephone_number": "718-979-2928",
            "fax_number": "718-979-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 15TH ST.",
            "address_2": "SUITE M1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "718-369-7560",
            "fax_number": "718-369-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELATTAR",
        "first_name": "AYMAN",
        "middle_name": "MOHAMED",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "014036-1",
            "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 Jun 23, 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.