Individual provider Active NPI

Shawn Abraham

  • Orthopedic Physical Therapist
  • Valley Stream, NY
National Provider Identifier
1760258198
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
051337 Issued in NU
Practice address
68 S Central Ave
Valley Stream, NY 11580-5445
Phone
(516) 825-1112
NPI assigned
Nov 27, 2023
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 051337 NU Primary

Addresses

Primary practice location

68 S Central Ave
Valley Stream, NY 11580-5445

Mailing address

61 Pearl St
New Hyde Park, NY 11040-3813
Phone (917) 562-3529

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240205000444 NY Practitioner - Physical Therapist in Private Practice 0446693709 Reassigns benefits to 3 organizations

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
New York Luna Care Physical Therapy PLLCGroup PAC ID 0840604666, 62 clinicians
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

Pearl River, NY 10965
Phone (866) 525-3175

3 Delaware Dr
Suite 202
New Hyde Park, NY 11042-1116
Phone (516) 622-6161

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051337NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Mar 1, 2024 Accepting new patients
New York Luna Care Physical Therapy PLLC CurrentSince Dec 23, 2024 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jan 1, 2024 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jan 1, 2024 Accepting new patients
Optum Medical Care, P.C. CurrentSince Mar 1, 2024 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

Philadelphia, PA 19195

Organizations & group practices 6

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": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1760258198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 PEARL ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403813",
            "telephone_number": "917-562-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 S CENTRAL AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805445",
            "telephone_number": "516-825-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": "051337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.