Michelle Lauren Brussel, MSPT – Physical Therapist

Key facts

NPI: 1720067572
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: 021063 (NY)
Practice address: 200 Glenbrook Rd
Nyack, NY 10960-1306
Phone: (917) 626-3601
NPI assigned: Jan 11, 2006
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

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.

PT and OT for Senior Rehab at Home PLLC Geriatric Physical Therapist · Brooklyn, NY · NPI 1811463003

Medicare reassignment NPD NY · PHYSICAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NY

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20060105000509	NY	Practitioner - Physical Therapist in Private Practice	2264455211	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
021063	NY	MD	Clinical Child & Adolescent Psychologist

Practice roles

Organization	Specialty	Status	New patients
PT and OT for Senior Rehab at Home PLLC	Physical Therapist	Current since Jun 18, 2025	Accepting new patients

Locations

171 Kings Hwy
Brooklyn, NY 11223
Phone (877) 722-7700

8008 45th Ave
Ofc
Elmhurst, NY 11373

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	021063	NY	Yes

Addresses

Primary practice location

200 Glenbrook Rd
Nyack, NY 10960-1306

Mailing address

200 Glenbrook Rd
Nyack, NY 10960-1306
Phone (917) 626-3601

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 3, 2011.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1720067572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GLENBROOK RD",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601306",
            "telephone_number": "917-626-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GLENBROOK RD",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601306",
            "telephone_number": "917-626-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSSEL",
        "first_name": "MICHELLE",
        "middle_name": "LAUREN",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyack, NY

All providers in Nyack, NY · Physical Therapist in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.