Saif Al Deen Rocaberte Odeh, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

050276-01 Issued in NY

Practice address

17119 Hillside Ave
Jamaica, NY 11432-4548

Phone

(718) 400-7000

NPI assigned

Jul 2, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Citimed Complete Medical Care PC

  • Clinic/Center
  • Rego Park, NY
  • NPI 1316543085
  NPD (past)

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1992541692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9719 31ST AVE",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113691845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17119 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324548",
            "telephone_number": "718-400-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "78A N Boundary Rd",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114301820",
            "country_code": "US",
            "telephone_number": "718-656-1245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODEH",
        "first_name": "SAIF AL DEEN",
        "middle_name": "ROCABERTE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050276-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justice Obi
• Angela Udochukwu Obiajunwa, RN
• Jessica Obidimalor, NURSE PRACTITIONER
• Eucharia Ophilia Oche
• Stephanie Ochild, PHARM D
• Florence Femi Odekunle
• Onah Anne Odili
• Olajumoke Odina, P.T.
• Ufuoma Ogadie Odjodu
• Jill Odom

• Physical Therapist in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.