Active NPI
Robert Conrad Broas Acong
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1922668409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 044299
- Practice address
- 468 Lafayette Ave
Brooklyn, NY 11205-4809 - Phone
- (718) 399-6234
- NPI assigned
- Jun 17, 2019
- 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 | 044299 | NY | Primary |
Addresses
Primary practice location
468 Lafayette Ave
Brooklyn, NY 11205-4809
Mailing address
3990 Riverside Park Blvd Apt 1205
Macon, GA 31210-1235
Phone (478) 951-7037
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medcare, LLC | Physical Therapist | Past | Accepting new patients |
| Lafayette Medical Office, PC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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": "1560729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560729600000",
"number": "1922668409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3990 RIVERSIDE PARK BLVD APT 1205",
"city": "MACON",
"state": "GA",
"postal_code": "312101235",
"telephone_number": "478-951-7037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "468 LAFAYETTE AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112054809",
"telephone_number": "718-399-6234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACONG",
"first_name": "ROBERT CONRAD",
"middle_name": "BROAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-17",
"last_updated": "2019-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "044299",
"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 Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.