PRO FORM PHYSICAL THERAPY PC
NPI 1740621697
Specialist in Bronx, NY
About Pro Form Physical Therapy Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRO FORM PHYSICAL THERAPY PC (NPI 1740621697) is a healthcare organization registered as a specialist in Bronx, New York and active in the NPI registry since July 2013. The organization lists Sam Hanna, Owner/physical Therapist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pro Form Physical Therapy Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Pro Form Physical Therapy PC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
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 Pro Form Physical Therapy PC's NPI number?
The NPI number for Pro Form Physical Therapy PC is 1740621697. It was assigned to this organization in the NPPES registry on July 8, 2013.
Where is Pro Form Physical Therapy PC located?
Pro Form Physical Therapy PC is located at 1973 University Ave, Bronx, NY 10453. The listed phone number is (718) 618-0052.
What is Pro Form Physical Therapy PC's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Pro Form Physical Therapy PC enrolled in Medicare?
Yes. Pro Form Physical Therapy PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Pro Form Physical Therapy PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Pro Form Physical Therapy PC. 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 Pro Form Physical Therapy PC was last updated on March 1, 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.
# Pro Form Physical Therapy Pc · NPI 1740621697
Specialist organization in Bronx, New York. Organization record, active in the CMS NPPES registry since July 8, 2013.
## Identity
- **NPI:** 1740621697 (Entity type: Organization)
- **Enumerated:** July 8, 2013
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Sam Hanna, OWNER/PHYSICAL THERAPIST
## Practice location
- **Address:** 1973 UNIVERSITY AVE, Bronx, NY 10453-4404
- **Phone:** (718) 618-0052 · **Fax:** (718) 534-4135
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Physical Therapist in Private Practice) reassign Medicare billing to this organization (form CMS-855R); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 1, 2016
---
Source: [NPI Profile](https://npiprofile.com/npi/1740621697) · Data from the CMS NPPES public registry.