Individual provider Active NPI

Jeremiah Josue

  • Physical Therapist
  • Elmhurst, NY
National Provider Identifier
1164629606
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
025735-1 Issued in NY
Practice address
8605 58TH Ave
Apt. 2
Elmhurst, NY 11373-4818
Phone
(646) 436-1964
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
No

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 025735-1 NY Primary

Addresses

Primary practice location

8605 58TH Ave
Apt. 2
Elmhurst, NY 11373-4818

Mailing address

8605 58TH Ave
Apt. 2
Elmhurst, NY 11373-4818

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
025735-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164629606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8605 58TH AVE",
            "address_2": "APT. 2",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8605 58TH AVE",
            "address_2": "APT. 2",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734818",
            "telephone_number": "646-436-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSUE",
        "first_name": "JEREMIAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025735-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, 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.