Active NPI
Nylton Tuibuen Basco, PT
- Geriatric Physical Therapist
- Coral Springs, FL
National Provider Identifier
1144547167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 12609
- Practice address
- 5900 W Sample Rd
Apt 304
Coral Springs, FL 33067-3248 - Phone
- (954) 345-7040
- NPI assigned
- Apr 29, 2010
- Last updated
- Apr 29, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 12609 | NC | Primary |
Addresses
Primary practice location
5900 W Sample Rd
Apt 304
Coral Springs, FL 33067-3248
Mailing address
5900 W Sample Rd
Apt 304
Coral Springs, FL 33067-3248
Phone (954) 345-7040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B200638761050 | Other | FL | DRIVER'S LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12609 | NC | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272499200000",
"number": "1144547167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 W SAMPLE RD",
"address_2": "APT 304",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330673248",
"telephone_number": "954-345-7040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 W SAMPLE RD",
"address_2": "APT 304",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330673248",
"telephone_number": "954-345-7040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASCO",
"first_name": "NYLTON",
"middle_name": "TUIBUEN",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-29",
"last_updated": "2010-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "NC",
"license": "12609",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "B200638761050",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.