Individual provider Active NPI

Cheska Mariah Balboa

  • Physical Therapist
  • Richmond Ill, NY
National Provider Identifier
1003620386
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P127453 Issued in NY
Practice address
107-02R Jamaica Ave
Richmond Ill, NY 11418
Phone
(347) 829-3890
Fax
(347) 829-3888
NPI assigned
Feb 5, 2025
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P127453 NY Primary

Addresses

Primary practice location

107-02R Jamaica Ave
Richmond Ill, NY 11418

Mailing address

107-02R Jamaica Ave
Richmond Ill, NY 11418
Phone (347) 829-3890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P127453NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Care PT PC Physical Therapist CurrentSince Feb 9, 2025 Accepting new patients

Locations

10702 Jamaica Ave
#R
Richmond Hill, NY 11418
Phone (718) 395-2727

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1003620386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107-02R JAMAICA AVE",
            "city": "RICHMOND ILL",
            "state": "NY",
            "postal_code": "11418",
            "telephone_number": "347-829-3890",
            "fax_number": "347-829-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107-02R JAMAICA AVE",
            "city": "RICHMOND ILL",
            "state": "NY",
            "postal_code": "11418",
            "telephone_number": "347-829-3890",
            "fax_number": "347-829-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALBOA",
        "first_name": "CHESKA MARIAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "P127453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.