Organization Active NPI

Evolution Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • Pearl River, NY
National Provider Identifier
1730419706
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
027446-1 Issued in NY
Legal business name
EVOLUTION PHYSICAL THERAPY, P.C.
Practice address
300 N Middletown Rd Ste 2
Pearl River, NY 10965-1295
Phone
(845) 494-1825
NPI assigned
Jan 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Authorized official

Name
Eva LarinoNPI 1629267281
Title
Owner
Phone
(845) 494-1825

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 027446-1 NY Primary
Physical Therapy Clinic/Center 261QP2000X 030442-1 NY

Addresses

Primary practice location

300 N Middletown Rd Ste 2
Pearl River, NY 10965-1295

Mailing address

6 Rockford Dr
West Nyack, NY 10994-1212

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100504000253 NY Part B Supplier - Clinic/Group Practice 1355479858 Receives reassigned benefits from 1 practitioner
Practice locations: Pearl River, NY

National Provider Directory

National Provider Directory

Locations

136 E 57th St
Ste 705
New York, NY 10022
Phone (212) 207-3177

Practitioners & affiliated clinicians

Practitioners 1

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": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1730419706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ROCKFORD DR",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109941212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N MIDDLETOWN RD STE 2",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651295",
            "telephone_number": "845-494-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "LARINO",
        "authorized_official_first_name": "EVA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-494-1825"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "027446-1",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "030442-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.