Organization Active NPI

Triboro Physical Therapy, PLLC

  • Specialist
  • Astoria, NY
National Provider Identifier
1700932969
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0219831 Issued in NY
Legal business name
TRIBORO PHYSICAL THERAPY, PLLC
Practice address
2923 24TH Ave
Astoria, NY 11102-1129
Phone
(718) 606-9513
NPI assigned
Jan 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Philip Serras, P.T.NPI 1942382510
Title
Partner
Phone
(718) 606-9513

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 0219831 NY Primary

Addresses

Primary practice location

2923 24TH Ave
Astoria, NY 11102-1129

Mailing address

2923 24TH Ave
Astoria, NY 11102-1129
Phone (718) 606-9513

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070312000223 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0840393112 Receives reassigned benefits from 2 practitioners
Practice locations: Astoria, NY

National Provider Directory

National Provider Directory

Locations

2923 24th Ave
Astoria, NY 11102
Phone (718) 606-9513

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": "1169942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700932969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 24TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021129",
            "telephone_number": "718-606-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2923 24TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021129",
            "telephone_number": "718-606-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIBORO PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SERRAS",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "718-606-9513",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "0219831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.