Individual provider Active NPI

Dorothy Joy Pedrena Racimo

  • Physical Therapist
  • New Hyde Park, NY
National Provider Identifier
1124156948
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023114 Issued in NY
Practice address
103 Terrace Blvd
New Hyde Park, NY 11040-4330
Phone
(347) 610-5761
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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 023114 NY Primary

Addresses

Primary practice location

103 Terrace Blvd
New Hyde Park, NY 11040-4330

Mailing address

103 Terrace Blvd
New Hyde Park, NY 11040-4330
Phone (347) 610-5761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191127001890 NY Practitioner - Physical Therapist in Private Practice 3678605995 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Skilled Care PT OT Services Physical Therapist CurrentSince Jan 19, 2025 Accepting new patients
Balance Physical Therapy & Rehabilitation PLLC Physical Therapist CurrentSince Apr 30, 2003 Accepting new patients
Progressive Physical Therapy Services, PC Physical Therapist Current Accepting new patients

Locations

4359 147th St
Flushing, NY 11355
Phone (718) 445-1205

Organizations & group practices 4

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1124156948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 TERRACE BLVD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110404330",
            "telephone_number": "347-610-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 TERRACE BLVD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110404330",
            "telephone_number": "347-610-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACIMO",
        "first_name": "DOROTHY JOY",
        "middle_name": "PEDRENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.