Individual provider Active NPI

Alyssa Jeanine Bernardo Villanueva, DPT, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1124760178
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
165 Division Ave
Brooklyn, NY 11211-7105
Phone
(718) 253-8000
NPI assigned
Apr 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 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 Primary

Addresses

Primary practice location

165 Division Ave
Brooklyn, NY 11211-7105

Mailing address

186 Lenox Rd Apt 5H
Brooklyn, NY 11226-2692
Phone (917) 936-8559

Other practice location 1

4618 Broadway
Astoria, NY 11103-1628
Phone (718) 274-4200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220505000701 NY Practitioner - Physical Therapist in Private Practice 3173910437 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Physical Therapy Services of Flatiron PCGroup PAC ID 1759784085, 112 clinicians
W Rehabilitation Associates PT and OT PLLCGroup PAC ID 8426321951, 8 clinicians
Health Sos PT PCGroup PAC ID 7214955533, 24 clinicians

Practice addresses (Care Compare)

138 5TH Ave
FL 2
New York, NY 10011-4367
Phone (212) 287-4257

165 Division Ave
Brooklyn, NY 11211-7105
Phone (718) 253-8000

203 -03 Union Turnpike
Bayside, NY 11364-3235
Phone (914) 400-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Services of Flatiron PC Physical Therapist CurrentSince Oct 7, 2022 Accepting new patients
Health Sos PT PC Physical Therapist CurrentSince Aug 3, 2024 Accepting new patients
W Rehabilitation Associates PT & OT PLLC Physical Therapist CurrentSince Apr 1, 2022 Accepting new patients

Locations

101 Arch St
Fl 8
Boston, MA 02110
Phone (212) 287-4257

22202 Union Tpke
Bayside, NY 11364
Phone (718) 479-6370

165 Division Ave
Brooklyn, NY 11211
Phone (718) 253-8000

138 5th Ave
Fl 2
New York, NY 10011
Phone (212) 287-4257

1255 5th Ave
Apt 6L
New York, NY 10029
Phone (914) 390-0080

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": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1124760178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 LENOX RD APT 5H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262692",
            "telephone_number": "917-936-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 DIVISION AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112117105",
            "telephone_number": "718-253-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4618 Broadway",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111031628",
            "country_code": "US",
            "telephone_number": "718-274-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "ALYSSA JEANINE",
        "middle_name": "BERNARDO",
        "name_prefix": "Dr.",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.