Individual provider Active NPI

Mark J Coleman

  • Physical Therapist
  • Poughkeepsie, NY
National Provider Identifier
1942335930
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0128421 Issued in NY
Practice address
76 Firemens Way
Poughkeepsie, NY 12603-6519
Phone
(845) 452-9220
Fax
(845) 454-2701
NPI assigned
Feb 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0128421 NY Primary

Addresses

Primary practice location

76 Firemens Way
Poughkeepsie, NY 12603-6519

Mailing address

76 S Randolph Ave
Poughkeepsie, NY 12601-5124
Phone (845) 471-5965

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190530000373 NY Practitioner - Physical Therapist in Private Practice 2769725001 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT and OT for Senior Rehab at Home PLLCGroup PAC ID 2668711573, 97 clinicians
Fox Rehabilitation Physical Therapy Services LLCGroup PAC ID 1355395179, 226 clinicians
Affinity Rehabilitation LLPGroup PAC ID 4789843376, 114 clinicians

Practice addresses (Care Compare)

171 Kings Hwy
Brooklyn, NY 11223-1023
Phone (914) 837-6538

1844 2ND Ave
New York, NY 10128-3862
Phone (877) 407-3422

3820 Bowne St
Flushing, NY 11354-5638
Phone (877) 407-3422

500 N Columbus Ave
Mount Vernon, NY 10552-1335
Phone (914) 266-3796

79 Flint Rd
Millbrook, NY 12545-6410
Phone (845) 266-2003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0128421NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Rehabilitation LLP CurrentSince Jun 25, 2024 Accepting new patients
PT and OT for Senior Rehab at Home PLLC Physical Therapist CurrentSince Jun 1, 2025 Accepting new patients

Locations

171 Kings Hwy
Brooklyn, NY 11223
Phone (877) 722-7700

8008 45th Ave
Ofc
Elmhurst, NY 11373

500 N Columbus Ave
Mount Vernon, NY 10552
Phone (914) 266-3796

1 Johnsarbor Dr W
Rochester, NY 14620
Phone (585) 532-7214

Organizations & group practices 3

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942335930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 S RANDOLPH AVE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126015124",
            "telephone_number": "845-471-5965",
            "fax_number": "845-454-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 FIREMENS WAY",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036519",
            "telephone_number": "845-452-9220",
            "fax_number": "845-454-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "MARK",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0128421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.