Individual provider Active NPI

Michael Stasi, PT,DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1891249348
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040658 Issued in NY
Practice address
9920 4TH Ave
Brooklyn, NY 11209-8333
Phone
(718) 238-9873
Fax
(718) 238-9874
NPI assigned
Aug 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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 040658 NY Primary

Addresses

Primary practice location

9920 4TH Ave
Brooklyn, NY 11209-8333

Mailing address

1351 Forest Ave
Staten Island, NY 10302-2049
Phone (718) 844-5350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240201003905 CA Practitioner - Physical Therapist in Private Practice 0345538146 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
H.D.P.R.G., Inc Physical Therapist CurrentSince Nov 13, 2023 Accepting new patients

Locations

5930 Adobe Rd
Twentynine Palms, CA 92277
Phone (760) 367-1743

56299 29 Palms Hwy
Yucca Valley, CA 92284
Phone (760) 367-1743

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": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1891249348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022049",
            "telephone_number": "718-844-5350",
            "fax_number": "718-390-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112098333",
            "telephone_number": "718-238-9873",
            "fax_number": "718-238-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASI",
        "first_name": "MICHAEL",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040658",
            "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 Aug 12, 2016; 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.