Individual provider Active NPI

Bryan James Paduano

  • Massage Therapist
  • North Massapequa, NY
National Provider Identifier
1235891615
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
028390 Issued in NY
Practice address
935 N Broadway
North Massapequa, NY 11758-2308
Phone
(516) 707-5915
NPI assigned
Oct 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 028390 NY Primary

Addresses

Primary practice location

935 N Broadway
North Massapequa, NY 11758-2308

Mailing address

935 N Broadway
North Massapequa, NY 11758-2308
Phone (516) 707-5915

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
028390NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hearts Holistic Wellness, Inc Massage Therapist CurrentSince Oct 17, 2021 Accepting new patients

Locations

935 N Broadway
North Massapequa, NY 11758
Phone (516) 707-5915

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1235891615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 N BROADWAY",
            "city": "NORTH MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582308",
            "telephone_number": "516-707-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 N BROADWAY",
            "city": "NORTH MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582308",
            "telephone_number": "516-707-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADUANO",
        "first_name": "BRYAN",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "028390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.

Verify at the official NPI Registry.