Individual provider Active NPI

Wilbert Cubillan, PT

  • Physical Therapist
  • Valley Stream, NY
National Provider Identifier
1134324122
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
019957 Issued in NY
Practice address
210 E Sunrise Hwy
Suite 101
Valley Stream, NY 11581-1329
Phone
(516) 596-2273
Fax
(516) 596-9606
NPI assigned
Jun 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 019957 NY Primary

Addresses

Primary practice location

210 E Sunrise Hwy
Suite 101
Valley Stream, NY 11581-1329

Mailing address

15928 92ND St
Howard Beach, NY 11414-3122
Phone (718) 529-4384

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
019957NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adept Physical Therapy, P.C. Physical Therapist PastSince Jul 1, 2007 Accepting new patients

Organizations & group practices 1

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": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134324122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15928 92ND ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143122",
            "telephone_number": "718-529-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E SUNRISE HWY",
            "address_2": "SUITE 101",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811329",
            "telephone_number": "516-596-2273",
            "fax_number": "516-596-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUBILLAN",
        "first_name": "WILBERT",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "019957",
            "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 Jul 8, 2007; 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.