Individual provider Active NPI

Maged Ellaboudi, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1750194890
Registry record updated Sep 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
053626 Issued in NY
Practice address
80 Madison Ave
New York, NY 10016-7420
Phone
(646) 337-2791
Fax
(212) 404-1824
NPI assigned
Jan 31, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2026

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 053626 NY Primary

Addresses

Primary practice location

80 Madison Ave
New York, NY 10016-7420

Mailing address

102 Madison Ave FL 8
New York, NY 10016-7584
Phone (212) 759-2282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260406002251 NY Practitioner - Physical Therapist in Private Practice 7012482235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Line Rehab PT PCGroup PAC ID 6204133861, 6 clinicians

Practice addresses (Care Compare)

3457 82ND St
Jackson Heights, NY 11372-2939
Phone (917) 765-5058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
High Line Rehab PT PC Physical Therapist CurrentSince Feb 24, 2026 Accepting new patients

Locations

3457 82nd St
Ste 1F
Jackson Hts, NY 11372
Phone (718) 446-8100

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.

NPI Registry JSON

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789257600000",
    "number": "1750194890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MADISON AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100167584",
            "telephone_number": "212-759-2282",
            "fax_number": "212-759-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100167420",
            "telephone_number": "646-337-2791",
            "fax_number": "212-404-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLABOUDI",
        "first_name": "MAGED",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-31",
        "last_updated": "2026-09-13",
        "certification_date": "2026-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "053626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2026; 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.