Individual provider Active NPI

Dalfry Javier Gutierrez, PT, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1093546137
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
052734 Issued in NY
Practice address
51 Audubon Ave FL 1
New York, NY 10032-2248
Phone
(212) 304-5794
NPI assigned
Aug 12, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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 052734 NY Primary

Addresses

Primary practice location

51 Audubon Ave FL 1
New York, NY 10032-2248

Mailing address

570 W 189TH St Apt 1D
New York, NY 10040-4322
Phone (347) 805-7170

Other practice location 1

3202 Bainbridge Ave Apt D
Bronx, NY 10467-3947
Phone (347) 805-7170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240919000166 NY Practitioner - Physical Therapist in Private Practice 0345781258 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

3202 Bainbridge Ave
Apt D
Bronx, NY 10467-3947
Phone (718) 881-9525

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
052734NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Oct 3, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Aug 9, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Aug 9, 2024 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Oct 3, 2024 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology PastSince Aug 1, 2024 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3202 Bainbridge Ave
Apt D
Bronx, NY 10467
Phone (718) 881-9507

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

51 Audubon Ave
Fl 1
New York, NY 10032
Phone (212) 304-5794

180 Fort Washington Ave
Ste 199
New York, NY 10032
Phone (212) 305-3535

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1093546137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 W 189TH ST APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100404322",
            "telephone_number": "347-805-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 AUDUBON AVE FL 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322248",
            "telephone_number": "212-304-5794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3202 Bainbridge Ave Apt D",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104673947",
            "country_code": "US",
            "telephone_number": "347-805-7170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "DALFRY",
        "middle_name": "JAVIER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052734",
            "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 Oct 8, 2024; 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.