Active NPI
Douglas Bautista Sagastizado
- Massage Therapist
- Babylon, NY
National Provider Identifier
1033799440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 031765
- Practice address
- 130 N Carll Ave
Babylon, NY 11702-2238 - Phone
- (631) 433-9502
- NPI assigned
- Apr 9, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 031765 | NY | Primary |
Addresses
Primary practice location
130 N Carll Ave
Babylon, NY 11702-2238
Mailing address
130 N Carll Ave
Babylon, NY 11702-2238
Phone (631) 433-9502
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 |
|---|---|---|---|
| 031765 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1033799440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 N CARLL AVE",
"city": "BABYLON",
"state": "NY",
"postal_code": "117022238",
"telephone_number": "631-433-9502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 N CARLL AVE",
"city": "BABYLON",
"state": "NY",
"postal_code": "117022238",
"telephone_number": "631-433-9502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA SAGASTIZADO",
"first_name": "DOUGLAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-09",
"last_updated": "2021-04-12",
"certification_date": "2021-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "NY",
"license": "031765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Babylon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.