Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ian Enrick Bartolome

Individual provider Physical Therapist · NPI 1083240279

Ian Enrick Bartolome is a Physical Therapist in Private Practice in Elmhurst, New York. Qualified in 2002, 24 years ago. Practices with Fresh Pond Physical Therapy PC, a 13-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
24
Licensed in
NY
In the registry since
2020
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Practice location Address checks out

5203 82nd St Fl 1
Elmhurst, NY 11373-4114
Phone: (347) 458-8497
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 042591 (NY)

Record details

NPI number1083240279
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 19, 2020
Last updated in NPPESMarch 19, 2020
Certification dateMarch 19, 2020
Mailing address5203 82nd St Fl 1, Elmhurst, NY 11373-4114

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Fresh Pond Physical Therapy Pc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Elmhurst