Organization Active NPI

Prime Rehab PT, PLLC

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1952545394
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
024408 Issued in NY
Legal business name
PRIME REHAB PT, PLLC
Practice address
4809 8TH Ave
Brooklyn, NY 11220-2213
Phone
(718) 686-1736
Fax
(718) 686-7098
NPI assigned
Apr 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2009

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

Authorized official

Name
Catherine Afdal
Title
Physical Therapist
Phone
(718) 686-1736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 024408 NY Primary

Addresses

Primary practice location

4809 8TH Ave
Brooklyn, NY 11220-2213

Mailing address

4809 8TH Ave
Brooklyn, NY 11220-2213
Phone (718) 686-1736

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091110000646 NY Part B Supplier - Clinic/Group Practice 9436297538 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241136000000",
    "number": "1952545394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4809 8TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202213",
            "telephone_number": "718-686-1736",
            "fax_number": "718-686-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 8TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202213",
            "telephone_number": "718-686-1736",
            "fax_number": "718-686-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME REHAB PT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-05-01",
        "status": "A",
        "authorized_official_last_name": "AFDAL",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "718-686-1736"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024408",
            "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 May 1, 2009; 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.