Individual provider Active NPI

Emil Bimbo Arguil Bergado, P.T.

  • Physical Therapist
  • Woodside, NY
National Provider Identifier
1124352414
Registry record updated Sep 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
022600 Issued in NY
Practice address
3211 55TH St
Apt. 1
Woodside, NY 11377-1906
Phone
(631) 839-5550
NPI assigned
Sep 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2009

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 022600 NY Primary

Addresses

Primary practice location

3211 55TH St
Apt. 1
Woodside, NY 11377-1906

Mailing address

3211 55TH St
Apt. 1
Woodside, NY 11377-1906
Phone (631) 839-5550

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
022600NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1253404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253404800000",
    "number": "1124352414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 55TH ST",
            "address_2": "APT. 1",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771906",
            "telephone_number": "631-839-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 55TH ST",
            "address_2": "APT. 1",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771906",
            "telephone_number": "631-839-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGADO",
        "first_name": "EMIL BIMBO",
        "middle_name": "ARGUIL",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-20",
        "last_updated": "2009-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2009; 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.