Active NPI
Ellen Micallef, PT
- Physical Therapist
- Whitestone, NY
National Provider Identifier
1255687224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 011630
- Practice address
- 24-06 169TH Street
Whitestone, NY 11357-4117 - Phone
- (718) 352-2766
- NPI assigned
- Jul 27, 2012
- Last updated
- Jul 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 011630 | NY | Primary |
Addresses
Primary practice location
24-06 169TH Street
Whitestone, NY 11357-4117
Mailing address
24-06 169TH Street
Whitestone, NY 11357-4117
Phone (718) 352-2766
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 |
|---|---|---|---|
| 011630 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343347200000",
"number": "1255687224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24-06 169TH STREET",
"city": "WHITESTONE",
"state": "NY",
"postal_code": "113574117",
"telephone_number": "718-352-2766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24-06 169TH STREET",
"city": "WHITESTONE",
"state": "NY",
"postal_code": "113574117",
"telephone_number": "718-352-2766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICALLEF",
"first_name": "ELLEN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-27",
"last_updated": "2012-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "011630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whitestone, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.