Active NPI
Michael Olynciw, PT, DPT
- Physical Therapist
- Astoria, NY
National Provider Identifier
1902818776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5968
- Practice address
- 2717 Crescent St
First Floor
Astoria, NY 11102-2507 - Phone
- (718) 545-0700
- Fax
- (718) 545-3282
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- 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 | 5968 | NY | Primary |
Addresses
Primary practice location
2717 Crescent St
First Floor
Astoria, NY 11102-2507
Mailing address
2717 Crescent St
First Floor
Astoria, NY 11102-2507
Phone (718) 545-0700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01290188 | Medicaid | NY |
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 |
|---|---|---|---|
| 5968 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389052800000",
"number": "1902818776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2717 CRESCENT ST",
"address_2": "FIRST FLOOR",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111022507",
"telephone_number": "718-545-0700",
"fax_number": "718-545-3282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2717 CRESCENT ST",
"address_2": "FIRST FLOOR",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111022507",
"telephone_number": "718-545-0700",
"fax_number": "718-545-3282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLYNCIW",
"first_name": "MICHAEL",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2014-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "5968",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01290188",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.