NPIMap

Organization Active NPI

PKL Physical Therapy & Wellness, PC

  • Physical Therapist
  • Amityville, NY
National Provider Identifier
1962594143
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
025489 Issued in NY
Legal business name
PKL PHYSICAL THERAPY & WELLNESS, PC
Practice address
11 Broadway
Amityville, NY 11701-2701
Phone
(631) 691-6900
Fax
(631) 691-6910
NPI assigned
Sep 28, 2006
Last updated
Oct 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Authorized official

Name
Parsa Karimi, DPTNPI 1942288998
Title
President
Phone
(631) 691-6900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 025489 NY Primary

Addresses

Primary practice location

11 Broadway
Amityville, NY 11701-2701

Mailing address

11 Broadway
Amityville, NY 11701-2701
Phone (631) 691-6900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101206000824 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6103874425 Receives reassigned benefits from 9 practitioners
Practice locations: Amityville, NY; Plainview, NY

National Provider Directory

National Provider Directory

Locations

11 Broadway
Amityville, NY 11701
Phone (516) 605-1700

111 Merrick Rd
Ste 5
Amityville, NY 11701
Phone (631) 691-6900

343 Broadway
Bethpage, NY 11714
Phone (516) 605-1700

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1962594143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012701",
            "telephone_number": "631-691-6900",
            "fax_number": "631-691-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012701",
            "telephone_number": "631-691-6900",
            "fax_number": "631-691-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PKL PHYSICAL THERAPY & WELLNESS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "KARIMI",
        "authorized_official_first_name": "PARSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-691-6900",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.