Individual provider Active NPI

Paul Henry Evora, MS, PT

  • Orthopedic Physical Therapist
  • New York, NY
National Provider Identifier
1104894765
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
020224 Issued in NY
Practice address
430 W 24TH St
Suite 1-F
New York, NY 10011-1334
Phone
(212) 741-5544
Fax
(212) 741-5895
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 020224 NY Primary

Addresses

Primary practice location

430 W 24TH St
Suite 1-F
New York, NY 10011-1334

Mailing address

430 W 24TH St
Apt 1F
New York, NY 10011-1328
Phone (718) 544-3620

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
020224NYMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1104894765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W 24TH ST",
            "address_2": "APT 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111328",
            "telephone_number": "718-544-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W 24TH ST",
            "address_2": "SUITE 1-F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111334",
            "telephone_number": "212-741-5544",
            "fax_number": "212-741-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVORA",
        "first_name": "PAUL",
        "middle_name": "HENRY",
        "credential": "MS, PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "020224",
            "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 Sep 20, 2018; 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.