Tina M Elderbaum, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0208991 Issued in NY

Practice address

197 Smithtown Blvd
Nesconset, NY 11767-1849

Phone

(631) 863-1290

Fax

(631) 863-3090

NPI assigned

May 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

T.L.C.Physical Therapy,P.C.Group PAC ID 7810909785, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• T.L.C.Physical Therapy,P.C.

  • Physical Therapist
  • Nesconset, NY
  • NPI 1538110838
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1821049065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 SMITHTOWN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671849",
            "telephone_number": "631-863-1290",
            "fax_number": "631-863-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 SMITHTOWN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671849",
            "telephone_number": "631-863-1290",
            "fax_number": "631-863-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDERBAUM",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0208991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Godefridus Jacobus Druif, D.O.
• Jamie Drury, M.A. CCC-SLP
• Ear Works Audiology PC
• Lorie Echerer-Vanriel, P.T.
• Rhonda R Edwards-Braithwaite, PA
• Marc Etts, LCSW
• Excel Urgent Care of Nesconset, PLLC
• Eye Vision Associates, LLP
• Sharon Eye, LPN
• Donna Fade, RN

• Physical Therapist in Nesconset, NY
• Providers in Nesconset, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.