Individual provider Active NPI

Robertino Marcelino Poblete

  • Physical Therapist
  • New York, NY
National Provider Identifier
1033848304
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
051823-01 Issued in NY
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

Updated by the provider on Feb 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20260213002987 NY Practitioner - Physical Therapist in Private Practice 1052891538 Reassigns benefits to 1 organization

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
Reddy Care Physical Therapy PCGroup PAC ID 5890685986, 139 clinicians

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

LicenseStateTypeSpecialty
051823NYMDPharmacist
051823-01NYMDPhysical Therapist
012090-01NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reddy Care Physical Therapy PC Physical Therapist CurrentSince Mar 10, 2026 Accepting new patients
Reddy Care Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Mar 10, 2026 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.

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.

Verify at the official NPI Registry.