NPIMap

Organization Active NPI

Sports Physical Therapy Occupationa Therapy and Rehabilitation Servic

  • Physical Therapist
  • New York, NY
National Provider Identifier
1902671704
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORTS PHYSICAL THERAPY OCCUPATIONA THERAPY AND REHABILITATION SERVIC
Practice address
333 W 52ND St Ste 801
New York, NY 10019-6238
Phone
(646) 912-9086
NPI assigned
Nov 21, 2023
Last updated
May 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Daniel Vaknin, PT
Title
VP
Phone
(516) 321-7801

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

333 W 52ND St Ste 801
New York, NY 10019-6238

Mailing address

3 Huntington Quadrangle Ste 103N
Melville, NY 11747-4601
Phone (516) 474-2816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240812001248 NY DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 0446140446 Practice locations: New York, NY

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Sports Phys Ther and Reha26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1902671704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HUNTINGTON QUADRANGLE STE 103N",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474601",
            "telephone_number": "516-474-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W 52ND ST STE 801",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100196238",
            "telephone_number": "646-912-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS PHYSICAL THERAPY OCCUPATIONA THERAPY AND REHABILITATION SERVIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-21",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "VAKNIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "516-321-7801",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.