Jeargian Formacion Decangchon, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

030834 Issued in NY

Practice address

7252 Metropolitan Ave
Middle Village, NY 11379-2100

Phone

(718) 326-0055

NPI assigned

May 7, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kinetic PT, OT, PLLC

  • Physical Therapist
  • Sunnyside, NY
  • NPI 1306498530
  NPD Authorized official

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

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1194043794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4263 LAYTON ST APT 4E",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113736447",
            "telephone_number": "347-260-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7252 METROPOLITAN AVE",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792100",
            "telephone_number": "718-326-0055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W 57th St",
            "address_2": "Suite 900",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100193211",
            "country_code": "US",
            "telephone_number": "212-981-1977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECANGCHON",
        "first_name": "JEARGIAN",
        "middle_name": "FORMACION",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-07",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vita M D'Angelo, SLP
• D&S Pharmacy LLC
• Cara Lily Daidone
• Emily Daingerfield, ATR-BC, LCAT
• Mailyn Mae De Dios, FNP
• Jillian Lauren Decoursey, LMHC
• Jessica Dedona
• Tamara Dekhkanova, OTR/L
• Luisa F Delgadillo
• Jesse Delman, LMSW

• Physical Therapist in Middle Village, NY
• Providers in Middle Village, 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 Oct 3, 2018; 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.