FRESH POND PHYSICAL THERAPY ASTORIA, P.C.
NPI 1477819084
Physical Therapist in Astoria, NY

Active since April 09, 2012
4618 BROADWAY, ASTORIA, NY 11103(718) 274-4200(718) 559-6784 Get Directions Write a Review

NPPES record last updated: May 20, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Fresh Pond Physical Therapy Astoria, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FRESH POND PHYSICAL THERAPY ASTORIA, P.C. (NPI 1477819084) is a healthcare organization registered as a physical therapist in Astoria, New York and active in the NPI registry since April 2012. The organization lists Liza Tan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1477819084
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameFRESH POND PHYSICAL THERAPY ASTORIA, P.C.
Location Address4618 BROADWAYAstoria, NY 11103-1628
Mailing Address6805 Fresh Pond RdRidgewood, NY 11385-5200 · (718) 456-2545 · Fax (718) 559-6784
Fax(718) 559-6784
Organization SubpartNo
Authorized OfficialLiza TanCeo · (718) 456-2543
Enumeration DateApril 9, 2012
Last NPPES UpdateMay 20, 2016
✔ NPI 1477819084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in NY · 015401-1
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
4618 BROADWAY, Astoria, NY 11103

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fresh Pond Physical Therapy Astoria, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Fresh Pond Physical Therapy Astoria, P.C., which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Physical Therapist in Private Practice
NPI 1982628764
6805 FRESH POND RD
Ridgewood, NY 11385
(718) 456-2545
3.7 mi
Physical Therapist in Private Practice
NPI 1043151137
17271 HENLEY RD
Jamaica, NY 11432
(914) 490-1221
7.1 mi
Physical Therapist in Private Practice
NPI 1275667339
2799 ROUTE 112 SUITE 5
Medford, NY 11763
(516) 374-6838
48 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fresh Pond Physical Therapy Astoria, P.C.'s NPI number?

The NPI number for Fresh Pond Physical Therapy Astoria, P.C. is 1477819084. It was assigned to this organization in the NPPES registry on April 9, 2012.

Where is Fresh Pond Physical Therapy Astoria, P.C. located?

Fresh Pond Physical Therapy Astoria, P.C. is located at 4618 Broadway, Astoria, NY 11103. The listed phone number is (718) 274-4200.

What is Fresh Pond Physical Therapy Astoria, P.C.'s specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Fresh Pond Physical Therapy Astoria, P.C. enrolled in Medicare?

Yes. Fresh Pond Physical Therapy Astoria, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fresh Pond Physical Therapy Astoria, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Fresh Pond Physical Therapy Astoria, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Fresh Pond Physical Therapy Astoria, P.C. was last updated on May 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.