Individual provider Active NPI

Mersim Gjonbalic, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1881984250
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
033413-1 Issued in NY
Practice address
263 7TH Ave
Suite 2a
Brooklyn, NY 11215-7247
Phone
(718) 369-8000
Fax
(718) 679-9598
NPI assigned
Apr 19, 2011
Last updated
Sep 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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 033413-1 NY Primary

Addresses

Primary practice location

263 7TH Ave
Suite 2a
Brooklyn, NY 11215-7247

Mailing address

263 7TH Ave
Suite 2a
Brooklyn, NY 11215-7247
Phone (718) 369-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190820001227 PA Practitioner - Physical Therapist in Private Practice 9830369628 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033413-1NYMDPhysical Therapist
033413NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Jul 1, 2019 Accepting new patients
Lehigh Valley Hospital Physical Therapist CurrentSince Aug 1, 2021 Accepting new patients
Lehigh Valley Hospital CurrentSince Aug 1, 2021 Accepting new patients
Genesis Medical Health PC Past Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

707 Hamilton St
Fl 4
Allentown, PA 18101
Phone (484) 862-3001

2901 Emrick Blvd
Ste 103
Bethlehem, PA 18020
Phone (610) 625-2169

700 Hawk Ridge Dr
Hamburg, PA 19526
Phone (610) 562-0170

470 N Lewis Rd
Limerick, PA 19468
Phone (610) 792-8800

1122 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (877) 407-4322

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, 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": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1881984250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 7TH AVE",
            "address_2": "SUITE 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112157247",
            "telephone_number": "718-369-8000",
            "fax_number": "718-679-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 7TH AVE",
            "address_2": "SUITE 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112157247",
            "telephone_number": "718-369-8000",
            "fax_number": "718-679-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GJONBALIC",
        "first_name": "MERSIM",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033413-1",
            "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 Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.