REVOLUTION PHYSICAL THERAPY PLLC
NPI 1689281842
Physical Therapist in New York, NY

Active since September 30, 2020
115 W 30TH ST RM 502, NEW YORK, NY 10001(631) 213-2394(212) 898-0470 Get Directions Write a Review

NPPES record last updated: December 9, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Dec 9, 2024, Aug 15, 2023, Nov 3, 2020 and 1 more (4 updates tracked since 2020).

About Revolution Physical Therapy Pllc NPPES

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

REVOLUTION PHYSICAL THERAPY PLLC (NPI 1689281842) is a healthcare organization registered as a physical therapist in New York, New York and active in the NPI registry since September 2020. The organization lists Kenneth Chang-hay Van, Owner, as its authorized official.

NPPES Registry Identity

NPI1689281842
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameREVOLUTION PHYSICAL THERAPY PLLC
Location Address115 W 30TH ST RM 502New York, NY 10001-4074
Mailing Address115 W 30th St Rm 502New York, NY 10001-4074 · (631) 231-2394 · Fax (212) 898-0470
Fax(212) 898-0470
Organization SubpartNo
Authorized OfficialKenneth Chang-hay VanOwner · (917) 816-0691
Enumeration DateSeptember 30, 2020
Last NPPES UpdateDecember 9, 20244 updates tracked since enumeration
NPPES CertifiedDecember 9, 2024
✔ NPI 1689281842 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
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.
115 W 30TH ST RM 502, New York, NY 10001

Other Identifiers 1

Other1275721524NY · Npi

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)

Revolution Physical Therapy Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Revolution Physical Therapy PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Physical Therapist in Private Practice
NPI 1275721524
115 W 30TH ST RM 502
New York, NY 10001
(631) 213-2394
✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1548761596
200 PARK AVENUE GROUND FLOOR
New York, NY 11372
(212) 953-9494
✔ Accepts Medicare0.9 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 Revolution Physical Therapy PLLC's NPI number?

The NPI number for Revolution Physical Therapy PLLC is 1689281842. It was assigned to this organization in the NPPES registry on September 30, 2020.

Where is Revolution Physical Therapy PLLC located?

Revolution Physical Therapy PLLC is located at 115 W 30th St Rm 502, New York, NY 10001. The listed phone number is (631) 213-2394.

What is Revolution Physical Therapy PLLC's specialty?

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

Is Revolution Physical Therapy PLLC enrolled in Medicare?

Yes. Revolution Physical Therapy PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revolution Physical Therapy PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Revolution Physical Therapy PLLC. 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, 1 practice at this address and 2 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 Revolution Physical Therapy PLLC was last updated on December 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.