Active NPI
Olivia Thadani Baesa, PT
- Physical Therapist
- Bellerose, NY
National Provider Identifier
1295370682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 039418
- Practice address
- 24519 Jericho Tpke
Bellerose, NY 11426-1414 - Phone
- (718) 343-6300
- NPI assigned
- Nov 9, 2019
- 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 | 039418 | NY | Primary |
Addresses
Primary practice location
24519 Jericho Tpke
Bellerose, NY 11426-1414
Mailing address
8635 Queens Blvd Apt 1H
Elmhurst, NY 11373-4408
Phone (516) 492-9896
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
| License | State | Type | Specialty |
|---|---|---|---|
| 039418 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573257600000",
"number": "1295370682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8635 QUEENS BLVD APT 1H",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113734408",
"telephone_number": "516-492-9896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24519 JERICHO TPKE",
"city": "BELLEROSE",
"state": "NY",
"postal_code": "114261414",
"telephone_number": "718-343-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAESA",
"first_name": "OLIVIA",
"middle_name": "THADANI",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-09",
"last_updated": "2019-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "039418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellerose, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.