Ma Theresa Enano Alvizo, BSPT
Individual provider Active NPI Physical Therapist · Bellmore, NY
NPI 1912920869 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1912920869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 019185-1 (NY)
- Practice address
- 2710 Grand Ave
Bellmore, NY 11710 - Phone
- (516) 781-9555
- Fax
- (516) 781-2871
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4420 Francis Lewis Blvd
Bayside, NY 11361-3041
Phone (718) 438-9369
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060227000230 | NY | Practitioner - Physical Therapist in Private Practice | 1759397904 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019185-1 | NY | MD | Clinical Psychologist |
| 019185 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alvizo Physical Therapy P.C. | Physical Therapist | Current |
Accepting new patients |
| Green Life Care | Physical Therapist | Past | Accepting new patients |
Locations
4420 Francis Lewis Blvd
Bayside, NY 11361
Phone (718) 225-8200
2710 Grand Ave
Bellmore, NY 11710
Phone (516) 781-9500
25220 Northern Blvd
Ste 210
Little Neck, NY 11362
Phone (516) 442-4077
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 019185-1 | NY | Yes |
Addresses
Primary practice location
2710 Grand Ave
Bellmore, NY 11710
Mailing address
2710 Grand Avenue
Bellmore, NY 11710
Phone (516) 781-9555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02691683 | Medicaid | NY |
Other providers in Bellmore, NY
- Steven Aletkin
- Melissa Mulayara Alex
- Allied Medical & Rehabilitation PC
- Laurie Alphonse
- Alvizo Physical Therapy P.C.
- Jessica Amaral
- Jessica Andreotti-Block
- Keith Brian Annapolen
- Apex Counseling, LCSW, P.C.
- Danielle Beth Appel
All providers in Bellmore, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.