Individual provider Active NPI

Sandra Mae Basco Salditos, P.T.

  • Physical Therapist
  • Astoria, NY
National Provider Identifier
1104071091
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027793-1 Issued in NY
Practice address
1806 26TH Ave
Second Floor
Astoria, NY 11102-3542
Phone
(646) 546-6695
NPI assigned
Nov 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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 027793-1 NY Primary

Addresses

Primary practice location

1806 26TH Ave
Second Floor
Astoria, NY 11102-3542

Mailing address

1806 26TH Ave
Second Floor
Astoria, NY 11102-3542
Phone (646) 546-6695

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181016002847 NY Practitioner - Physical Therapist in Private Practice 8628320868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3765 Riverdale Ave
Suite 5
Bronx, NY 10463-1845
Phone (718) 543-3181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027793NYMDGeneral Practice Dentistry
027793-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Outcome Physical Therapy, PLLC Physical Therapist CurrentSince Dec 1, 2017 Accepting new patients

Locations

3765 Riverdale Ave
Ste 5
Bronx, NY 10463
Phone (718) 543-3181

Organizations & group practices 1

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": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1104071091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 26TH AVE",
            "address_2": "SECOND FLOOR",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111023542",
            "telephone_number": "646-546-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 26TH AVE",
            "address_2": "SECOND FLOOR",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111023542",
            "telephone_number": "646-546-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALDITOS",
        "first_name": "SANDRA MAE",
        "middle_name": "BASCO",
        "name_prefix": "Miss",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027793-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.