Active NPI
Joshua Amiel Elizalde Castro, PTRP, PTA, PT
- Physical Therapy Assistant
- New York, NY
National Provider Identifier
1023765005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 012312-01
- Practice address
- 1345 Avenue of the Americas
New York, NY 10105 - Phone
- (929) 622-6080
- NPI assigned
- Mar 9, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 045098-01 | NY | |
| Physical Therapy Assistant | 225200000X | 012312-01 | NY | Primary |
Addresses
Primary practice location
1345 Avenue of the Americas
New York, NY 10105
Mailing address
73 Meetinghouse Ridge
Apartment 205
Meriden, CT 06450
Phone (929) 622-6080
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
| License | State | Type | Specialty |
|---|---|---|---|
| 045098-01 | NY | MD | Physical Therapist |
| 012312-01 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646784000000",
"number": "1023765005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73 MEETINGHOUSE RIDGE",
"address_2": "APARTMENT 205",
"city": "MERIDEN",
"state": "CT",
"postal_code": "06450",
"telephone_number": "929-622-6080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 AVENUE OF THE AMERICAS",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10105",
"telephone_number": "929-622-6080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTRO",
"first_name": "JOSHUA AMIEL",
"middle_name": "ELIZALDE",
"name_prefix": "Mr.",
"credential": "PTRP, PTA, PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-09",
"last_updated": "2022-03-09",
"certification_date": "2022-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "045098-01",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "012312-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.