NPIMap

Organization Active NPI

Kines Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Bronx, NY
National Provider Identifier
1891420642
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
KINES PHYSICAL THERAPY PLLC
Practice address
3265 Johnson Ave Ste 211
Bronx, NY 10463-3539
Phone
(760) 819-1921
NPI assigned
Jul 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brando Lydell LakesNPI 1801386503
Title
President
Phone
(929) 755-2682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

3265 Johnson Ave Ste 211
Bronx, NY 10463-3539

Mailing address

3656 Johnson Ave Apt 6G
Bronx, NY 10463-1616
Phone (760) 819-1921

Other practice location 1

3656 Johnson Ave Apt 6G
Bronx, NY 10463-1616
Phone (760) 819-1921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20221216000230 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0345619243 Receives reassigned benefits from 3 practitioners
Practice locations: Bronx, NY
O20260617002499 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8628540960 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory
Tax ID family
Kines Physical Therapy PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3265 Johnson Ave
Ste 108
Bronx, NY 10463

219 Sherman Ave
New York, NY 10034

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1891420642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3656 JOHNSON AVE APT 6G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631616",
            "telephone_number": "760-819-1921",
            "fax_number": "929-810-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3265 JOHNSON AVE STE 211",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104633539",
            "telephone_number": "760-819-1921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3656 Johnson Ave Apt 6G",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104631616",
            "country_code": "US",
            "telephone_number": "760-819-1921",
            "fax_number": "929-810-3278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINES PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-17",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "LAKES",
        "authorized_official_first_name": "BRANDO",
        "authorized_official_middle_name": "LYDELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "929-755-2682"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.