Individual provider Active NPI

Kyle Paolo Gorriceta Suarez

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1003761065
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
052360 Issued in NY
Practice address
1981 Jerome Ave
Bronx, NY 10453-1803
Phone
(718) 589-2200
Fax
(718) 589-2205
NPI assigned
Mar 3, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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 052360 NY Primary

Addresses

Primary practice location

1981 Jerome Ave
Bronx, NY 10453-1803

Mailing address

1981 Jerome Ave
Bronx, NY 10453-1803
Phone (718) 589-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260408001546 NY Practitioner - Physical Therapist in Private Practice 7719452689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

45 Hopkins Ave
Apt 33
Jersey City, NJ 07306-1520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
052360NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Protherapy Rehabilitation OT, PT, SLP, PLLC Physical Therapist CurrentSince Mar 4, 2026 Accepting new patients

Locations

1981 Jerome Ave
Bronx, NY 10453
Phone (718) 589-2200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1772496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1003761065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 JEROME AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104531803",
            "telephone_number": "718-589-2200",
            "fax_number": "718-589-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1981 JEROME AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104531803",
            "telephone_number": "718-589-2200",
            "fax_number": "718-589-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "KYLE PAOLO",
        "middle_name": "GORRICETA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-03",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.