Individual provider Active NPI

Teresita Corpus

  • Physical Therapist
  • Holbrook, NY
National Provider Identifier
1013315407
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
036255 Issued in NY
Practice address
20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616
Phone
(631) 467-3700
Fax
(631) 467-0928
NPI assigned
Dec 17, 2014
Last updated
Dec 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

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 036255 NY Primary

Addresses

Primary practice location

20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616

Mailing address

4 Huntley Crescent
Ontario, KITCHENER N2M2R3
CA
Phone (519) 635-6138

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150128001066 NY Practitioner - Physical Therapist in Private Practice 7911221643 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PRN Physical, Occupational and Speech Therapy Network, PLLC Physical Therapist CurrentSince Dec 1, 2014 Accepting new patients
PRN Physical, Occupational and Speech Therapy Network, PLLC CurrentSince Dec 1, 2014 Accepting new patients

Locations

345 Northern Blvd
Albany, NY 12204
Phone (518) 462-1689

20 Peachtree Ct
Ste 105
Holbrook, NY 11741
Phone (518) 253-4983

2222 Sullivan Trl
Ste 105
Easton, PA 18040
Phone (574) 261-7058

Organizations & group practices 2

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": "1418774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1013315407",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "4 HUNTLEY CRESCENT",
            "city": "ONTARIO",
            "state": "KITCHENER",
            "postal_code": "N2M2R3",
            "telephone_number": "519-635-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-467-3700",
            "fax_number": "631-467-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORPUS",
        "first_name": "TERESITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-17",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; 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.