Individual provider Active NPI

Tatyana Irinina, DPT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1912057787
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023912 Issued in NY
Practice address
520 Bloomingdale Rd
Staten Island, NY 10309-2061
Phone
(718) 605-1300
Fax
(718) 615-8739
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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 023912 NY Primary

Addresses

Primary practice location

520 Bloomingdale Rd
Staten Island, NY 10309-2061

Mailing address

19 Edison St
Staten Island, NY 10306-3410
Phone (917) 977-1067

Other identifiers 1

IdentifierTypeStateIssuer
000218970101OtherNYHEALTH PLUS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041013000257 NY Practitioner - Physical Therapist in Private Practice 3870553027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab on Wheels OT PT PLLCGroup PAC ID 0042585358, 49 clinicians

Practice addresses (Care Compare)

174 Bay 29TH St
Suite C1
Brooklyn, NY 11214-5020
Phone (718) 395-7445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023912NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prokinetics Physical Therapy P.C. Physical Therapist CurrentSince May 9, 2024 Accepting new patients
Avantgarde Rehabilitation Limited Liability Company Physical Therapist PastSince Mar 2, 2018 Accepting new patients
Staten Island Center for Alternative Therapies, LLP Physical Therapist Past Accepting new patients

Locations

174 Bay 29th St
Ste C1
Brooklyn, NY 11214
Phone (646) 750-4455

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1912057787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063410",
            "telephone_number": "917-977-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 BLOOMINGDALE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092061",
            "telephone_number": "718-605-1300",
            "fax_number": "718-615-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRININA",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "000218970101",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.