Individual provider Active NPI

Ereny Atallah

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1831708270
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
04588201 Issued in NY
Practice address
237 Brookfield Ave # 10308
Staten Island, NY 10308-1441
Phone
(347) 884-6102
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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 04588201 NY Primary

Addresses

Primary practice location

237 Brookfield Ave # 10308
Staten Island, NY 10308-1441

Mailing address

237 Brookfield Ave # 10308
Staten Island, NY 10308-1441
Phone (347) 884-6102

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201118001607 NY Practitioner - Physical Therapist in Private Practice 0446661706 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehab on Wheels OT PT PLLCGroup PAC ID 0042585358, 49 clinicians

Practice addresses (Care Compare)

174 Bay 29TH St
Suite C1
Brooklyn, NY 11214-5020
Phone (718) 395-7445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04588201NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab on Wheels OT PT PLLC Physical Therapist CurrentSince Aug 13, 2024 Accepting new patients
Hands of Hope PT PC Physical Therapist CurrentSince Feb 12, 2024 Accepting new patients
Prokinetics Physical Therapy P.C. Physical Therapist CurrentSince Aug 13, 2024 Accepting new patients

Locations

837 E 149th St
Bronx, NY 10455
Phone (718) 569-8662

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

8009 5th Ave
Brooklyn, NY 11209
Phone (718) 748-0513

1134 Flatbush Ave
Brooklyn, NY 11226
Phone (347) 218-8204

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

8003 211th St
Queens Vlg, NY 11427
Phone (718) 464-8948

1432 Hylan Blvd
Staten Island, NY 10305
Phone (718) 238-6161

1752 Francis Lewis Blvd
Whitestone, NY 11357
Phone (718) 746-9494

8620 Jamaica Ave
Woodhaven, NY 11421
Phone (347) 396-3153

Organizations & group practices 4

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": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1831708270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 BROOKFIELD AVE # 10308",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103081441",
            "telephone_number": "347-884-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 BROOKFIELD AVE # 10308",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103081441",
            "telephone_number": "347-884-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATALLAH",
        "first_name": "ERENY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "04588201",
            "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 Mar 1, 2021; 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.