Active NPI
Menatalla Mahmoud, PT, DPT
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1871180448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 046617-01
- Practice address
- 87 Fort Greene PL Ste 2
Brooklyn, NY 11217-1203 - Phone
- (718) 522-2658
- NPI assigned
- Dec 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 046617-01 | NY | Primary |
Addresses
Primary practice location
87 Fort Greene PL Ste 2
Brooklyn, NY 11217-1203
Mailing address
390 Kings Hwy
Brooklyn, NY 11223-1614
Phone (347) 345-8370
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046617 | NY | MD | Pharmacist |
| 046617-01 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Movevolution, Inc | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1871180448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 KINGS HWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112231614",
"telephone_number": "347-345-8370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 FORT GREENE PL STE 2",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112171203",
"telephone_number": "718-522-2658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHMOUD",
"first_name": "MENATALLA",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-29",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "046617-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.