Organization Active NPI

Grand Rehab PT PC

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1710371653
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GRAND REHAB PT PC
Practice address
153 Bay 26TH St
Brooklyn, NY 11214-4994
Phone
(347) 702-9958
Fax
(347) 507-2022
NPI assigned
Mar 27, 2015
Last updated
Jun 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Authorized official

Name
Dr. Adam Gazdzinski, DPTNPI 1124236336
Title
Provider
Phone
(646) 863-8353

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
Physical Therapist 225100000X Primary

Addresses

Primary practice location

153 Bay 26TH St
Brooklyn, NY 11214-4994

Mailing address

153 Bay 26TH St
Brooklyn, NY 11214-4994
Phone (347) 702-9958

Other identifiers 1

IdentifierTypeStateIssuer
04869994MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170725003749 NY Part B Supplier - Clinic/Group Practice 6709156656 Receives reassigned benefits from 5 practitioners
Practice locations: Brooklyn, NY; Ridgewood, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1710371653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 BAY 26TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144994",
            "telephone_number": "347-702-9958",
            "fax_number": "347-710-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 BAY 26TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144994",
            "telephone_number": "347-702-9958",
            "fax_number": "347-507-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND REHAB PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-27",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "GAZDZINSKI",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "646-863-8353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04869994",
            "state": "NY"
        }
    ],
    "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 6, 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.