Ignite Rehab PT PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

022730 Issued in NY

Legal business name

IGNITE REHAB PT PC

Practice address

3000 Ocean Pkwy Apt 2J
Brooklyn, NY 11235-8344

Phone

(718) 714-4650

NPI assigned

May 13, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Roland Paqueo, DOCTOR OF PTNPI 1548306335

Title

PT/Owner

Phone

(718) 714-4650

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roland Paqueo, DPT

  • Physical Therapist
  • Elmhurst, NY
  • NPI 1548306335
  Medicare reassignment NPD Authorized official
• Annabelle Ramos Tungcab, RPT

  • Physical Therapist
  • Elmhurst, NY
  • NPI 1033587936
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1003263534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 OCEAN PKWY APT 2J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358344",
            "telephone_number": "718-714-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 OCEAN PKWY APT 2J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358344",
            "telephone_number": "718-714-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE REHAB PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-13",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "PAQUEO",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "718-714-4650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DOCTOR OF PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.