Individual provider Active NPI

Paul Defelice

  • Physical Therapist
  • New Rochelle, NY
National Provider Identifier
1114565678
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9656-1 Issued in NY
Practice address
140A Suite 2 Lockwood Ave
New Rochelle, NY 10801
Phone
(914) 636-4466
NPI assigned
Dec 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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 9656-1 NY Primary

Addresses

Primary practice location

140A Suite 2 Lockwood Ave
New Rochelle, NY 10801

Mailing address

130 Linden Tree Rd
Wilton, CT 06897-1616
Phone (914) 636-4466

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9656-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark R. Weigle, MD, P.C. PastSince Dec 22, 2019 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CGEHCA/Endpoint/CGEHCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CGEHCA

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": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1114565678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LINDEN TREE RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068971616",
            "telephone_number": "914-636-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140A SUITE 2 LOCKWOOD AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "10801",
            "telephone_number": "914-636-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFELICE",
        "first_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "9656-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.