Therapeutic Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

019468 Issued in NY

Legal business name

THERAPEUTIC PHYSICAL THERAPY PC

Practice address

1570 Old Country Rd
Westbury, NY 11590-5238

Phone

(516) 338-0412

Fax

(516) 338-1106

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Leila Montefrio Hisole Ceballos, BSPTNPI 1932247590

Title

President

Phone

(631) 839-4059

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bienvenido Poncardas Ceballos Jr., BSPT

  • Physical Therapist
  • Westbury, NY
  • NPI 1558409110
  Medicare reassignment NPD
• Leila Montefrio Hisole Ceballos, BSPT

  • Physical Therapist
  • Deer Park, NY
  • NPI 1932247590
  NPD Authorized official
• Mary Monaco Keller, ED.D.

  • Clinical Psychologist
  • Westbury, NY
  • NPI 1043254089
  NPD (past)
• Russell Roy Santos Leviste, PT

  • Physical Therapist
  • Astoria, NY
  • NPI 1508277849
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1093853657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MONMOUTH ST",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292514",
            "telephone_number": "631-839-4059",
            "fax_number": "631-254-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 OLD COUNTRY RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905238",
            "telephone_number": "516-338-0412",
            "fax_number": "516-338-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "HISOLE CEBALLOS",
        "authorized_official_first_name": "LEILA",
        "authorized_official_middle_name": "MONTEFRIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-839-4059",
        "authorized_official_credential": "BSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "019468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Rehabilitation Institute, Inc.
• Kalpana Thenmalai
• Therapeutic Energy Child Care Centers, Inc.
• Therapeutic Energy Day Care Centers, LLC
• Therapeutic Energy of Westbury, Inc (TP Energy)
• Cassandra C Thomas
• Joseph Thomas, RPH
• Leslie Thomas
• Sarah Ann Thomas
• Sharon Thomas, OTR/L

• Physical Therapist in Westbury, NY
• Providers in Westbury, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.