NPIMap

Organization Active NPI

Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Occupational Therapist
  • Hartsdale, NY
National Provider Identifier
1699539452
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
SPORTS PHYSICAL THERAPY OCCUPATIONAL THERAPY AND REHABILITATION SERVIC
Practice address
210 N Central Ave Ste 330
Hartsdale, NY 10530-1951
Phone
(914) 946-5685
NPI assigned
Feb 12, 2024
Last updated
Feb 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Daniel Vaknin
Title
VP
Phone
(516) 321-7801

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

210 N Central Ave Ste 330
Hartsdale, NY 10530-1951

Mailing address

3 Huntington Quadrangle Ste 103N
Melville, NY 11747-4601
Phone (516) 474-2816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241121002554 NY DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 0446140446 Practice locations: Hartsdale, NY

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Sports Phys Ther and Reha26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

210 N Central Ave
Ste 330
Hartsdale, NY 10530
Phone (914) 873-1878

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1699539452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HUNTINGTON QUADRANGLE STE 103N",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474601",
            "telephone_number": "516-474-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N CENTRAL AVE STE 330",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301951",
            "telephone_number": "914-946-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS PHYSICAL THERAPY OCCUPATIONAL THERAPY AND REHABILITATION SERVIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "VAKNIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "516-321-7801"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsdale, NY

Sources for this page

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