Individual provider Active NPI

Rose Ann Yu Tamayo, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1124349519
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01351100 Issued in NJ
Practice address
200 W 57TH St
Suite 900
New York, NY 10019-3211
Phone
(212) 981-1977
Fax
(212) 643-9192
NPI assigned
Jun 19, 2010
Last updated
Jan 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 032391-1 NY
Physical Therapist 225100000X 40QA01351100 NJ Primary

Addresses

Primary practice location

200 W 57TH St
Suite 900
New York, NY 10019-3211

Mailing address

61 Broadway
Suite 2824
New York, NY 10006-2701
Phone (212) 981-1977

Other names 1

  • Rose Ann Clarete Yu Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031001449 NJ Practitioner - Physical Therapist in Private Practice 6103064431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Bergen Spine and Rehabilitation, LLCGroup PAC ID 2163528498, 2 clinicians

Practice addresses (Care Compare)

136 N Washington Ave
Suite 103
Bergenfield, NJ 07621-1776
Phone (201) 387-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01351100NJMDPhysical Therapist
032391-1NYMDPhysical Therapist
032391NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bergen Spine & Rehabilitation, LLC Physical Therapist CurrentSince Aug 4, 2024 Accepting new patients
James a Kennedy Physical Therapist PLLC Past Accepting new patients
Interfysio, LLC. Past Accepting new patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist PastSince Dec 7, 2025 Accepting new patients

Locations

136 N Washington Ave
Ste 103
Bergenfield, NJ 07621
Phone (201) 387-2800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1276905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1124349519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 BROADWAY",
            "address_2": "SUITE 2824",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062701",
            "telephone_number": "212-981-1977",
            "fax_number": "212-643-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 57TH ST",
            "address_2": "SUITE 900",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193211",
            "telephone_number": "212-981-1977",
            "fax_number": "212-643-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAYO",
        "first_name": "ROSE ANN",
        "middle_name": "YU",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-19",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032391-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01351100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE ANN",
            "last_name": "YU",
            "middle_name": "CLARETE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 12, 2011; 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.