Individual provider Active NPI

Eliezer Rotblat

  • Physical Therapist
  • Astoria, NY
National Provider Identifier
1720264310
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
015568-1 Issued in NY
Practice address
2534 Steinway St
Astoria, NY 11103-3702
Phone
(718) 777-5243
Fax
(718) 777-5250
NPI assigned
Jan 14, 2008
Last updated
Nov 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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 015568-1 NY Primary

Addresses

Primary practice location

2534 Steinway St
Astoria, NY 11103-3702

Mailing address

681 Tilden Ave
Teaneck, NJ 07666-1847
Phone (646) 234-5689

Other identifiers 1

IdentifierTypeStateIssuer
015568-1OtherNYLICENSE#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051004000580 NY Practitioner - Physical Therapist in Private Practice 2365477874 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015568-1NYMDPhysical Therapist
015568NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Medical Services PC CurrentSince Apr 1, 2016 Accepting new patients
Epic Long Island CurrentSince May 25, 2016 Accepting new patients
Core Physical Therapy Services PC Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Feb 1, 2014 Accepting new patients
New York Physical and Occupational Therapy Services, PLLC Physical Therapist CurrentSince Oct 20, 2020 Accepting new patients
Epilepsy Foundation of L.I. CurrentSince May 25, 2016 Accepting new patients
Welllife Network Inc CurrentSince Nov 15, 2004 Accepting new patients
Welllife Network Inc., CurrentSince Nov 15, 2004 Accepting new patients
Welllife Network Inc. Past Accepting new patients
Energetic Physical Therapy Past Accepting new patients

Locations

16 Sumner Pl
Brooklyn, NY 11206
Phone (718) 336-9500

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

2244 119th St
College Point, NY 11356
Phone (718) 445-4700

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

14202 20th Ave
#3
Flushing, NY 11351

14202 20th Ave
Fl 3
Flushing, NY 11351
Phone (718) 559-0516

800 Northern Blvd
Great Neck, NY 11021
Phone (516) 829-8450

20905 Jamaica Ave
Queens Village, NY 11428
Phone (631) 920-8302

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1720264310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 TILDEN AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661847",
            "telephone_number": "646-234-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033702",
            "telephone_number": "718-777-5243",
            "fax_number": "718-777-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTBLAT",
        "first_name": "ELIEZER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-14",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015568-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "015568-1",
            "state": "NY"
        }
    ],
    "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 Nov 2, 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.