Individual provider Active NPI

Angelo A Pompeo, DPT

  • Physical Therapist
  • Taos, NM
National Provider Identifier
1093062770
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4178 Issued in NM
Practice address
1398 Weimer Rd
Suite 203
Taos, NM 87571-6397
Phone
(575) 737-0304
Fax
(575) 737-0383
NPI assigned
Aug 13, 2012
Last updated
Mar 5, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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 4178 NM Primary

Addresses

Primary practice location

1398 Weimer Rd
Suite 203
Taos, NM 87571-6397

Mailing address

1398 Weimer Rd
Suite 203
Taos, NM 87571-6397
Phone (575) 737-0304

Other identifiers 1

IdentifierTypeStateIssuer
433833386MedicaidNM

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4178NMMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1093062770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 WEIMER RD",
            "address_2": "SUITE 203",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716397",
            "telephone_number": "575-737-0304",
            "fax_number": "575-737-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1398 WEIMER RD",
            "address_2": "SUITE 203",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716397",
            "telephone_number": "575-737-0304",
            "fax_number": "575-737-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMPEO",
        "first_name": "ANGELO",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-13",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433833386",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.