Individual provider Active NPI

Felixberto Enriquez Bernal, PT

  • Physical Therapist
  • Woodside, NY
National Provider Identifier
1164020590
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
041650 Issued in NY
Practice address
3759 61St St Ste M2
Woodside, NY 11377-2590
Phone
(718) 424-2273
Fax
(718) 424-2278
NPI assigned
Oct 16, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2025

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 041650 NY Primary

Addresses

Primary practice location

3759 61St St Ste M2
Woodside, NY 11377-2590

Mailing address

30 S Broadway
Yonkers, NY 10701-3712
Phone (973) 896-9548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250627002385 NY Practitioner - Physical Therapist in Private Practice 2860853371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041650NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Care Physical Therapy P.C. Physical Therapist CurrentSince Oct 19, 2020 Accepting new patients
Summit Care Physical Therapy - Yonkers PLLC Physical Therapist CurrentSince Jun 6, 2025 Accepting new patients

Locations

3759 61st St
Ste M2
Woodside, NY 11377
Phone (718) 424-2273

Organizations & group practices 2

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": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1164020590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107013712",
            "telephone_number": "973-896-9548",
            "fax_number": "917-634-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3759 61ST ST STE M2",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772590",
            "telephone_number": "718-424-2273",
            "fax_number": "718-424-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL",
        "first_name": "FELIXBERTO",
        "middle_name": "ENRIQUEZ",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-16",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.