Individual provider Active NPI

Steven Rozov

  • Physical Therapist
  • Lake Como, NJ
National Provider Identifier
1841709789
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01756700 Issued in NJ
Practice address
1719 Main St
Lake Como, NJ 07719-3097
Phone
(732) 894-9200
Fax
(732) 894-9202
NPI assigned
Sep 22, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 40QA01756700 NJ Primary

Addresses

Primary practice location

1719 Main St
Lake Como, NJ 07719-3097

Mailing address

1719 Main St
Lake Como, NJ 07719-3097
Phone (732) 894-9200

Other identifiers 1

IdentifierTypeStateIssuer
40QA01756700OtherNJPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190815002935 NY Practitioner - Physical Therapist in Private Practice 9436415577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Chiropractic and Physical Therapy, PLLCGroup PAC ID 9537218482, 7 clinicians

Practice addresses (Care Compare)

1163 Forest Ave
Staten Island, NY 10310-2408
Phone (718) 727-0055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Chiropractic & Physical Therapy, PLLC CurrentSince Jul 15, 2019 Accepting new patients

Locations

1163 Forest Ave
Staten Island, NY 10310
Phone (718) 727-0055

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, 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": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841709789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 MAIN ST",
            "city": "LAKE COMO",
            "state": "NJ",
            "postal_code": "077193097",
            "telephone_number": "732-894-9200",
            "fax_number": "732-894-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 MAIN ST",
            "city": "LAKE COMO",
            "state": "NJ",
            "postal_code": "077193097",
            "telephone_number": "732-894-9200",
            "fax_number": "732-894-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZOV",
        "first_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01756700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "40QA01756700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Como, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.