Individual provider Active NPI

Edward Zdanowicz, PT,DPT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1699229153
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040707 Issued in NY
Practice address
33 Richmond Hill Rd
Staten Island, NY 10314-5950
Phone
(718) 982-6340
Fax
(718) 982-5358
NPI assigned
Aug 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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 040707 NY Primary

Addresses

Primary practice location

33 Richmond Hill Rd
Staten Island, NY 10314-5950

Mailing address

1351 Forest Ave
Staten Island, NY 10302-2049
Phone (718) 844-5350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161018002245 NY Practitioner - Physical Therapist in Private Practice 9335437722 Reassigns benefits to 1 organization
I20191028000640 NJ Practitioner - Physical Therapist in Private Practice 9335437722 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

433 Hackensack Ave
FL 2
Hackensack, NJ 07601-6316
Phone (201) 880-5930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040707NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Nov 1, 2020 Accepting new patients
Miracle Homecare Physical Therapy LLC Physical Therapist CurrentSince Nov 24, 2023 Accepting new patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Sep 30, 2019 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

433 Hackensack Ave
Fl 2
Hackensack, NJ 07601
Phone (201) 343-1717

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

414 Eagle Rock Ave
Ste 107
West Orange, NJ 07052
Phone (917) 603-7930

900 Route 9 N
Ste 410
Woodbridge, NJ 07095

2133 Ralph Ave
Brooklyn, NY 11234
Phone (718) 451-1400

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

231 Beach 116th St
Rockaway Park, NY 11694
Phone (718) 474-2224

1351 Forest Ave
Staten Island, NY 10302
Phone (718) 390-0060

33 Richmond Hill Rd
Staten Island, NY 10314
Phone (718) 982-5358

1243 Woodrow Rd
Unit 323
Staten Island, NY 10309
Phone (718) 844-5350

1243 Woodrow Rd
Ste 323
Staten Island, NY 10309
Phone (718) 966-0111

Organizations & group practices 3

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": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1699229153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022049",
            "telephone_number": "718-844-5350",
            "fax_number": "718-390-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 RICHMOND HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145950",
            "telephone_number": "718-982-6340",
            "fax_number": "718-982-5358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDANOWICZ",
        "first_name": "EDWARD",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.