Individual provider Active NPI

John Thomas

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1750506853
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039429 Issued in NY
Practice address
25 Fanning St
Staten Island, NY 10314-5307
Phone
(718) 289-7004
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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 039429 NY Primary

Addresses

Primary practice location

25 Fanning St
Staten Island, NY 10314-5307

Mailing address

657 Collfield Ave
Staten Island, NY 10314-4258
Phone (718) 619-0170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170809002719 NY Practitioner - Physical Therapist in Private Practice 9335410307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Rehab LLCGroup PAC ID 3375936495, 59 clinicians

Practice addresses (Care Compare)

16 W 16TH St
Apt 4PN
New York, NY 10011-0173
Phone (855) 678-8887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Rehab Ny LLC Physical Therapist CurrentSince Oct 28, 2024 Accepting new patients
Prestige Rehab LLC Physical Therapist CurrentSince Oct 28, 2024 Accepting new patients
Rehab on Wheels OT PT PLLC Physical Therapist CurrentSince Oct 12, 2017 Accepting new patients
Prokinetics Physical Therapy P.C. Physical Therapist PastSince Jul 5, 2023 Accepting new patients
N/a PastSince Jul 28, 2024 Accepting new patients

Locations

8419 Bay Pkwy
Brooklyn, NY 11214
Phone (718) 259-0199

174 Bay 29th St
Ste C1
Brooklyn, NY 11214
Phone (646) 750-4455

Organizations & group practices 5

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1750506853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 COLLFIELD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144258",
            "telephone_number": "718-619-0170",
            "fax_number": "718-698-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 FANNING ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145307",
            "telephone_number": "718-289-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.