Active NPI
Delena Mae Caagbay, PT
- Physical Therapist
- Boise, ID
National Provider Identifier
1295839447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT1638
- Practice address
- 230 West Mallard Dr
#A
Boise, ID 83706 - Phone
- (208) 422-9826
- Fax
- (208) 422-9855
- NPI assigned
- Sep 9, 2006
- Sex
- Female
- 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 | PT1638 | ID | Primary |
Addresses
Primary practice location
230 West Mallard Dr
#A
Boise, ID 83706
Mailing address
PO Box 711185
Salt Lake City, UT 84171
Phone (801) 942-3311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8063143 | Medicaid | ID |
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 |
|---|---|---|---|
| PT1638 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295839447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 711185",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84171",
"telephone_number": "801-942-3311",
"fax_number": "801-942-5455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 WEST MALLARD DR",
"address_2": "#A",
"city": "BOISE",
"state": "ID",
"postal_code": "83706",
"telephone_number": "208-422-9826",
"fax_number": "208-422-9855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAAGBAY",
"first_name": "DELENA",
"middle_name": "MAE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT1638",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8063143",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.