Active NPI
Jefferson Garcia Garrovillas, PT
- Physical Therapist
- Croton on Hudson, NY
National Provider Identifier
1275704173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 025551-1
- Practice address
- 27 Scenic Dr Apt P
Croton on Hudson, NY 10520-1821 - Phone
- (646) 479-9214
- NPI assigned
- Mar 18, 2008
- Reactivated
- Dec 1, 2022
- Sex
- Male
- Sole proprietor
- No
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 | 025551-1 | NY | Primary |
Addresses
Primary practice location
27 Scenic Dr Apt P
Croton on Hudson, NY 10520-1821
Mailing address
27 Scenic Dr Apt P
Croton on Hudson, NY 10520-1821
Phone (646) 479-9214
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 |
|---|---|---|---|
| 025551-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1275704173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 SCENIC DR APT P",
"city": "CROTON ON HUDSON",
"state": "NY",
"postal_code": "105201821",
"telephone_number": "646-479-9214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 SCENIC DR APT P",
"city": "CROTON ON HUDSON",
"state": "NY",
"postal_code": "105201821",
"telephone_number": "646-479-9214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARROVILLAS",
"first_name": "JEFFERSON",
"middle_name": "GARCIA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-18",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"deactivation_date": "2022-11-18",
"reactivation_date": "2022-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "025551-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Croton on Hudson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.