Individual provider Active NPI

Ellaine Thomas, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1962540047
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027212 Issued in NY
Practice address
83 Maiden LN
New York, NY 10038-4812
Phone
(212) 780-2379
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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 027212 NY Primary

Addresses

Primary practice location

83 Maiden LN
New York, NY 10038-4812

Mailing address

2 Brookdell Dr
Hartsdale, NY 10530-1709
Phone (914) 320-8968

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131209001689 NY Practitioner - Physical Therapist in Private Practice 4688801152 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Nysarc Inc. Nyc ChapterGroup PAC ID 7214030634, 20 clinicians

Practice addresses (Care Compare)

83 Maiden LN
New York, NY 10038-4812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027212NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespire, Inc. CurrentSince Sep 30, 2015 Accepting new patients
Nysarc Inc CurrentSince Jan 6, 2010 Accepting new patients
Epilepsy Foundation of L.I. CurrentSince Mar 11, 2016 Accepting new patients
Lifespire, Inc. CurrentSince Sep 30, 2015 Accepting new patients
Epic Long Island CurrentSince Mar 11, 2016 Accepting new patients

Locations

21301 Northern Blvd
Fl 2
Bayside, NY 11361
Phone (718) 721-5444

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

16210 Jamaica Ave
Ste 7
Jamaica, NY 11432
Phone (718) 454-2700

83 Maiden Ln
Fl 6
New York, NY 10038
Phone (212) 780-2378

159 E 125th St
Fl 2
New York, NY 10035
Phone (212) 360-5600

83 Maiden Ln
New York, NY 10038
Phone (212) 780-2578

83 Maiden Ln
Fl 7
New York, NY 10038
Phone (212) 780-2564

Organizations & group practices 5

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1962540047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BROOKDELL DR",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301709",
            "telephone_number": "914-320-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 MAIDEN LN",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384812",
            "telephone_number": "212-780-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ELLAINE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.