Individual provider Active NPI

Gezel Tamayo Villanueva-Fischberg, MS, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1144489840
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010519-1 Issued in NY
Practice address
3 E 65TH St
Suite 4a
New York, NY 10065-6527
Phone
(212) 535-2621
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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 010519-1 NY Primary
Physical Therapist 225100000X 40QA00726200 NJ

Addresses

Primary practice location

3 E 65TH St
Suite 4a
New York, NY 10065-6527

Mailing address

1626 Hudson Park
Edgewater, NJ 07020-1570
Phone (646) 977-9548

Other names 1

  • Gezel Tamayo Villanueva Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100222000407 NY Practitioner - Physical Therapist in Private Practice 4688718141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tamayo Physical Therapy PCGroup PAC ID 5890839369, 8 clinicians

Practice addresses (Care Compare)

3 E 65TH St
Apt 4a
New York, NY 10065-6551
Phone (212) 535-2621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
010519-1NYMDClinical Psychologist
40QA00726200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tamayo Physical Therapy P.C. Physical Therapist CurrentSince Mar 29, 2009 Accepting new patients

Locations

3 E 65th St
Apt 4A
New York, NY 10065
Phone (212) 535-2621

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1144489840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 HUDSON PARK",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201570",
            "telephone_number": "646-977-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E 65TH ST",
            "address_2": "SUITE 4A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656527",
            "telephone_number": "212-535-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA-FISCHBERG",
        "first_name": "GEZEL",
        "middle_name": "TAMAYO",
        "credential": "MS, PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010519-1",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00726200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GEZEL",
            "last_name": "VILLANUEVA",
            "middle_name": "TAMAYO",
            "credential": "MS, PT",
            "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 Sep 23, 2014; 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.