Camilo Maravilla

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

016721 Issued in NY

Practice address

700 Post Rd
Scarsdale, NY 10583-5063

Phone

(914) 722-6540

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heartshare Wellness LTDGroup PAC ID 8921992967, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: camillo.maravilla.p2@direct.ucpnyc.nextgenshare.com

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.

• Heartshare Wellness, LTD.

  • Public Health or Welfare Agency
  • Brooklyn, NY
  • NPI 1487895371
  Medicare reassignment Care Compare group
• Therapeutic Associates, Inc.

  • Clinical Social Worker
  • Bronxville, NY
  • NPI 1427420280
  Medicare reassignment NPD
• United Cerebral Palsy of New York City Inc

  • Rehabilitation Clinic/Center
  • New York, NY
  • NPI 1730302019
  Medicare reassignment NPD
• Federation Employment and Guidance Service, Inc

  • Developmental Disabilities Clinic/Center
  • New York, NY
  • NPI 1942243084
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184830093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 156TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 POST RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835063",
            "telephone_number": "914-722-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAVILLA",
        "first_name": "CAMILO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Mandel, LCSW
• Yonatan Y Mandelbaum, PSYD
• Manish Manek, RPH
• Danielle Manich
• Mick Mannello, DPT
• Marc Andrew Horowitz MD PC
• Marchele Optical Inc. (Pearle Vision)
• Kirsten Marchesano, LCSW
• Alexandra Marcus, PTA
• Ivy April Marcus

• Physical Therapist in Scarsdale, NY
• Providers in Scarsdale, NY by specialty
• Physical Therapist in New York

• 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.
• 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.