Individual provider Active NPI

Artem Kovyazin, PT,DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1922644517
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045283 Issued in NY
Practice address
2148 Ocean Ave
Brooklyn, NY 11229-1483
Phone
(718) 872-7002
Fax
(718) 872-6899
NPI assigned
Nov 19, 2019
Last updated
Nov 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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 045283 NY Primary

Addresses

Primary practice location

2148 Ocean Ave
Brooklyn, NY 11229-1483

Mailing address

900 Route 9 N
Woodbridge, NJ 07095-1025
Phone (201) 801-7141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191125000921 NY Practitioner - Physical Therapist in Private Practice 9133551526 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Manual Physical Therapy PCGroup PAC ID 1153747308, 3 clinicians

Practice addresses (Care Compare)

2600 Netherland Ave
Bronx, NY 10463-4813
Phone (929) 800-2011

2600 Netherland Ave
Suite 121
Bronx, NY 10463-4801
Phone (929) 800-2011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Priority One Therapy PT OT SLP PLLC Single Specialty CurrentSince Jul 1, 2020 Accepting new patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Nov 18, 2019 Accepting new patients
Integrative Manual Physical Therapy PC Single Specialty CurrentSince Nov 1, 2020 Accepting new patients
Netherland Physical Therapy and Occupational Therapy PLLC Physical Therapist CurrentSince Mar 25, 2022 Accepting new patients
Jag-One Physical Therapy, LLC PastSince Nov 24, 2019 Accepting new patients
Jag-One Physical Therapy, LLC PastSince Nov 24, 2019 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

2600 Netherland Ave
Ste 121
Bronx, NY 10463
Phone (718) 548-1590

1414 Newkirk Ave
Brooklyn, NY 11226
Phone (718) 434-4311

2148 Ocean Ave
Brooklyn, NY 11229
Phone (718) 375-2505

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

261 E 78th St
New York, NY 10075
Phone (212) 249-4501

99 W Hawthorne Ave
Ste 210
Valley Stream, NY 11580
Phone (718) 305-1190

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1922644517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROUTE 9 N",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951025",
            "telephone_number": "201-801-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291483",
            "telephone_number": "718-872-7002",
            "fax_number": "718-872-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVYAZIN",
        "first_name": "ARTEM",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.