Individual provider Active NPI

Alvin Nimo Tupaz, PT

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1023199056
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24252 Issued in NY
Practice address
3640 Main St
Basement Level
Flushing, NY 11354-6521
Phone
(718) 886-4288
Fax
(718) 886-4788
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 24252 NY Primary

Addresses

Primary practice location

3640 Main St
Basement Level
Flushing, NY 11354-6521

Mailing address

6433 98TH St
LL1
Rego Park, NY 11374-3321
Phone (718) 544-6677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040515000130 NY Practitioner - Physical Therapist in Private Practice 6204826803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

151 W 46TH St
Suite 801
New York, NY 10036-0346
Phone (212) 470-0360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24252NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
48TH St Physical Therapy P C Physical Therapist CurrentSince Jan 1, 2015 Accepting new patients
Sujit Bhattacharya MD Past Accepting new patients
Mamaroneck Physical Therapy PC Physical Therapist Past Accepting new patients
Woodhaven Physical Therapy & Rehab Services PLLC Physical Therapist Past Accepting new patients

Locations

1053 Morris Park Ave
Bronx, NY 10461
Phone (646) 872-0183

7146 110th St
Bsmt
Forest Hills, NY 11375
Phone (718) 687-2474

115 W 30th St
Rm 500B
New York, NY 10001
Phone (212) 470-0360

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 5

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023199056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6433 98TH ST",
            "address_2": "LL1",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743321",
            "telephone_number": "718-544-6677",
            "fax_number": "718-544-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 MAIN ST",
            "address_2": "BASEMENT LEVEL",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546521",
            "telephone_number": "718-886-4288",
            "fax_number": "718-886-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUPAZ",
        "first_name": "ALVIN",
        "middle_name": "NIMO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "24252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.