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

Mohamed Khallaf

Individual provider Physical Therapist · NPI 1174068720

Mohamed Khallaf is a Physical Therapist in Private Practice in Ridgewood, New York. Qualified in 1999, 27 years ago. Accepts Medicare assignment. Licensed in New York and Texas.

Years since qualifying
27
Licensed in
NY, TX
In the registry since
2017
Specialties on file
6
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Practice location Address checks out

6805 Fresh Pond Rd
Ridgewood, NY 11385-5200
Phone: (718) 456-2543
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Physical Therapist Taxonomy 225100000X · Licence 1345001 (TX)
Geriatric Physical Therapist Taxonomy 2251G0304X
Human Factors Physical Therapist Taxonomy 2251H1300X
Pediatric Physical Therapist Taxonomy 2251P0200X · Licence 036856 (NY)
Orthopedic Physical Therapist Taxonomy 2251X0800X

Record details

NPI number1174068720
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 5, 2017
Last updated in NPPESJuly 6, 2021
Certification dateJuly 6, 2021
Mailing address1500 Julianas Way, Cedar Park, TX 78613-7182

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Ridgewood