Individual provider Active NPI

Jans Byel Bueno Raymundo, PTA

  • Physical Therapy Assistant
  • Ozone Park, NY
National Provider Identifier
1255105433
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
01396101 Issued in NY
Practice address
8427 102ND Ave
Ozone Park, NY 11416-2028
Phone
(929) 698-6616
NPI assigned
Nov 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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 01396101 NY Primary

Addresses

Primary practice location

8427 102ND Ave
Ozone Park, NY 11416-2028

Mailing address

8427 102ND Ave
Ozone Park, NY 11416-2028
Phone (929) 698-6616

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
01396101NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1255105433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8427 102ND AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114162028",
            "telephone_number": "929-698-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8427 102ND AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114162028",
            "telephone_number": "929-698-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMUNDO",
        "first_name": "JANS BYEL",
        "middle_name": "BUENO",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "01396101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.