Jan Michael Abergas Bacalzo, PT

Primary specialty

SpecialistTaxonomy code 174400000X

License

027723-1 Issued in NY

Practice address

3270 31St St
Astoria, NY 11106-2643

Phone

(718) 626-2699

Fax

(718) 626-0923

NPI assigned

Nov 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC

  • Physical Therapist
  • Great Neck, NY
  • NPI 1841526399

  NY

  Medicare reassignment NPD
• Physiocare Physical Therapy PC

  • Physical Therapist
  • Astoria, NY
  • NPI 1366600793
  NPD (past)

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1255513404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 33RD ST",
            "address_2": "SUITE 403",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111062329",
            "telephone_number": "718-707-6970",
            "fax_number": "718-732-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 31ST ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111062643",
            "telephone_number": "718-626-2699",
            "fax_number": "718-626-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACALZO",
        "first_name": "JAN MICHAEL",
        "middle_name": "ABERGAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "027723-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne Axman, DPM
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• Rommel Baquiran Babaan, PHARM.D.
• Joe Bachner, LCSW
• Kristina Badalova, PHYSICIAN ASSISTANT
• Carmen E Baez, LCSW
• Rawattie Bahadour
• Aicha Bahri

• All providers in Astoria, NY
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.