Individual provider Active NPI

Moncy Cherian Varghese, MPT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1134664014
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
043498 Issued in NY
Practice address
318 Seguine Ave
Staten Island, NY 10309-3941
Phone
(646) 725-8245
NPI assigned
Dec 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 010751-1 NY
Physical Therapist 225100000X 043498 NY Primary

Addresses

Primary practice location

318 Seguine Ave
Staten Island, NY 10309-3941

Mailing address

231 Merrill Ave FL 1
Staten Island, NY 10314-3239
Phone (646) 725-8245

Other practice location 1

261 Weed Ave
Staten Island, NY 10306-4709
Phone (646) 725-8245

Other practice location 2

1835 Richmond Rd
Staten Island, NY 10306-2560
Phone (646) 725-8245

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
043498NYMDPhysical Therapist
010751-1NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1134664014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MERRILL AVE FL 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143239",
            "telephone_number": "646-725-8245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 SEGUINE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093941",
            "telephone_number": "646-725-8245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "261 Weed Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103064709",
            "country_code": "US",
            "telephone_number": "646-725-8245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1835 Richmond Rd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103062560",
            "country_code": "US",
            "telephone_number": "646-725-8245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "MONCY",
        "middle_name": "CHERIAN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-30",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "010751-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.