Active NPI
Gina Dimaculangan
- Physical Therapist
- Santa Fe, NM
National Provider Identifier
1225586357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-4894
- Practice address
- 2401 South Pacheco Street
Santa Fe, NM 87505 - Phone
- (561) 969-8505
- NPI assigned
- Sep 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1247702 | TX | |
| Physical Therapist | 225100000X | PT-4894 | NM | Primary |
Addresses
Primary practice location
2401 South Pacheco Street
Santa Fe, NM 87505
Mailing address
2401 South Pacheco Street
Santa Fe, NM 87505
Phone (561) 969-8505
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT-4894 | NM | MD | Physical Therapist |
| 1247702 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629331200000",
"number": "1225586357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 SOUTH PACHECO STREET",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87505",
"telephone_number": "561-969-8505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 SOUTH PACHECO STREET",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87505",
"telephone_number": "561-969-8505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMACULANGAN",
"first_name": "GINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-19",
"last_updated": "2021-08-19",
"certification_date": "2021-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1247702",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "PT-4894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.