Individual provider Active NPI

Michael Baranov

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1710934765
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021269 Issued in NY
Practice address
4119 18TH Ave
Brooklyn, NY 11218-5709
Phone
(718) 975-3515
Fax
(718) 975-3514
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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 021269 NY Primary

Addresses

Primary practice location

4119 18TH Ave
Brooklyn, NY 11218-5709

Mailing address

15611 Aguilar Ave # 1018
Flushing, NY 11367-2732
Phone (718) 975-3515

Other practice location 1

15611 Aguilar Ave # 1018
Flushing, NY 11367-2732
Phone (718) 975-3515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000354 NY Practitioner - Physical Therapist in Private Practice 4880666775 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael Baranov Physical Therapy PCGroup PAC ID 0244297620, 2 clinicians

Practice addresses (Care Compare)

7182 Parsons Blvd
Fresh Meadows, NY 11365-4599
Phone (718) 380-4750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rego Park Counseling LLC CurrentSince Dec 3, 2025 Accepting new patients
Rego Park Counseling LLC CurrentSince Dec 3, 2025 Accepting new patients
Rego Park Counseling LLC Current Accepting new patients
Bienetre Medical PC Physical Therapist Past Accepting new patients
Trif Chiropractic PC PastSince Oct 24, 2021 Accepting new patients

Organizations & group practices 7

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1710934765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15611 AGUILAR AVE # 1018",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672732",
            "telephone_number": "718-975-3515",
            "fax_number": "718-975-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185709",
            "telephone_number": "718-975-3515",
            "fax_number": "718-975-3514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15611 Aguilar Ave # 1018",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113672732",
            "country_code": "US",
            "telephone_number": "718-975-3515",
            "fax_number": "718-975-3514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARANOV",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021269",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 18, 2021; 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.