Organization Active NPI

Acosta Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Fresh Meadows, NY
National Provider Identifier
1922345271
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
028426-1 Issued in NY
Legal business name
ACOSTA PHYSICAL THERAPY PC
Practice address
6134 188TH St
Suite 208
Fresh Meadows, NY 11365-2719
Phone
(718) 264-1979
Fax
(718) 254-3020
NPI assigned
Jan 7, 2013
Last updated
Sep 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Authorized official

Name
Alvaro A Acosta, DPTNPI 1932232907
Title
President
Phone
(516) 312-0082

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 028426-1 NY Primary

Addresses

Primary practice location

6134 188TH St
Suite 208
Fresh Meadows, NY 11365-2719

Mailing address

219-32 64TH Avenue
3Rd Floor
Oakland Gardens, NY 11364
Phone (516) 312-0082

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130416000290 NY Part B Supplier - Clinic/Group Practice 6103062203 Receives reassigned benefits from 1 practitioner
Practice locations: Fresh Meadows, NY

National Provider Directory

National Provider Directory

Locations

6134 188th St
Ste 208
Fresh Meadows, NY 11365
Phone (516) 312-0082

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1922345271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219-32 64TH AVENUE",
            "address_2": "3RD FLOOR",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "516-312-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6134 188TH ST",
            "address_2": "SUITE 208",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652719",
            "telephone_number": "718-264-1979",
            "fax_number": "718-254-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACOSTA PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-312-0082",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "028426-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.