Active NPI
Robertino Marcelino Poblete
- Physical Therapist
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 051823-01
- Practice address
- 1345 Avenue of the Americas FL 11
New York, NY 10105-0013 - Phone
- (212) 981-1977
- Fax
- (646) 786-4026
- NPI assigned
- Jun 9, 2022
- Sex
- Male
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 012090-01 | NY | |
| Physical Therapist | 225100000X | 051823-01 | NY | Primary |
Addresses
Primary practice location
1345 Avenue of the Americas FL 11
New York, NY 10105-0013
Mailing address
245 Elmwood St
Valley Stream, NY 11581-2641
Phone (424) 558-7901
Other practice location 1
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone (516) 829-0030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
475 Northern Blvd
Great Neck, NY 11021-4802
Phone (516) 829-0030
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051823 | NY | MD | Pharmacist |
| 051823-01 | NY | MD | Physical Therapist |
| 012090-01 | NY | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reddy Care Physical Therapy PC | Physical Therapist | Current | Accepting new patients |
| Reddy Care Physical and Occupational Therapy PLLC | Physical Therapist | Current | Accepting new patients |
Locations
27278 Grand Central Pkwy
Floral Park, NY 11005
Phone (516) 344-0030
475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023
2421 Long Beach Rd
Oceanside, NY 11572
Phone (516) 766-1717
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 and National Provider Directory roles.
-
- Specialist
- Great Neck, NY
- NPI 1477052967
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770249600000",
"number": "1033848304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 ELMWOOD ST",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115812641",
"telephone_number": "424-558-7901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 AVENUE OF THE AMERICAS FL 11",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101050013",
"telephone_number": "212-981-1977",
"fax_number": "646-786-4026"
}
],
"practiceLocations": [
{
"address_1": "475 Northern Blvd Ste 11",
"address_purpose": "LOCATION",
"city": "Great Neck",
"state": "NY",
"postal_code": "110214802",
"country_code": "US",
"telephone_number": "516-829-0030",
"fax_number": "516-466-7723",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POBLETE",
"first_name": "ROBERTINO",
"middle_name": "MARCELINO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-09",
"last_updated": "2026-02-05",
"certification_date": "2026-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "012090-01",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "051823-01",
"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 Feb 5, 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.