Active NPI
Rommel O R Ballesteros, PT
- Physical Therapist
- Staten Island, NY
National Provider Identifier
1285851196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 020092-1
- Practice address
- 128 Aviston Street
Staten Island, NY 10306-5323 - Phone
- (917) 257-0927
- Fax
- (718) 979-7005
- NPI assigned
- Apr 20, 2007
- 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 | 020092-1 | NY | Primary |
Addresses
Primary practice location
128 Aviston Street
Staten Island, NY 10306-5323
Mailing address
128 Aviston Street
Staten Island, NY 10306
Phone (917) 257-0927
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 |
|---|---|---|---|
| 020092-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379030400000",
"number": "1285851196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 AVISTON STREET",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10306",
"telephone_number": "917-257-0927",
"fax_number": "718-979-7005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 AVISTON STREET",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103065323",
"telephone_number": "917-257-0927",
"fax_number": "718-979-7005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLESTEROS",
"first_name": "ROMMEL",
"middle_name": "O R",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-20",
"last_updated": "2013-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "020092-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.