Individual provider Active NPI

Fabiola Caicedo, PTA

  • Physical Therapy Assistant
  • Valley Stream, NY
National Provider Identifier
1114833704
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
009732-01 Issued in NY
Practice address
140 W Merrick Rd
Valley Stream, NY 11580-5511
Phone
(516) 423-4652
NPI assigned
Aug 21, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 009732-01 NY Primary

Addresses

Primary practice location

140 W Merrick Rd
Valley Stream, NY 11580-5511

Mailing address

21229 Hillside Ave Apt 5Ee
Queens Village, NY 11427-1847
Phone (347) 256-7559

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

NPI Registry JSON

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

{
    "created_epoch": "1787270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1114833704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21229 HILLSIDE AVE APT 5EE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271847",
            "telephone_number": "347-256-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W MERRICK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805511",
            "telephone_number": "516-423-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAICEDO",
        "first_name": "FABIOLA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-21",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "009732-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; 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.