Revolution Physiotherapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REVOLUTION PHYSIOTHERAPY PLLC

Practice address

36 Plaza St E Ste 1a
Brooklyn, NY 11238-5039

Phone

(516) 544-9479

NPI assigned

Nov 7, 2018

Last updated

Mar 1, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey SadayaNPI 1295071900

Title

Owner

Phone

(516) 680-9521

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Sadaya

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1295071900
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1700354883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 STERLING PL APT 4I",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384669",
            "telephone_number": "516-544-9479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 PLAZA ST E STE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112385039",
            "telephone_number": "516-544-9479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Sterling Pl Apt 4I",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112384669",
            "country_code": "US",
            "telephone_number": "516-544-9479",
            "fax_number": "516-357-5066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVOLUTION PHYSIOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "SADAYA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-680-9521",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.