Individual provider Active NPI

Diego Emanuel Contreras

  • Physical Therapy Assistant
  • Cedarhurst, NY
National Provider Identifier
1215551783
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
012018 Issued in NY
Practice address
657 Central Ave
Cedarhurst, NY 11516-2320
Phone
(516) 812-9575
NPI assigned
Jun 1, 2020
Last updated
Jun 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 012018 NY Primary

Addresses

Primary practice location

657 Central Ave
Cedarhurst, NY 11516-2320

Mailing address

657 Central Ave
Cedarhurst, NY 11516-2320
Phone (516) 812-9575

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

LicenseStateTypeSpecialty
012018NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1215551783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 CENTRAL AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162320",
            "telephone_number": "516-812-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 CENTRAL AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162320",
            "telephone_number": "516-812-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONTRERAS",
        "first_name": "DIEGO",
        "middle_name": "EMANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "012018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.