NPIMap

Organization Active NPI

Daniel M. Antonino Prof. Corp.

  • Orthopedic Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1306030622
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
0669 Issued in NV
Legal business name
DANIEL M. ANTONINO PROF. CORP.
Practice address
7955 W Sahara Ave
Suite #103
Las Vegas, NV 89117-7910
Phone
(702) 233-3288
Fax
(702) 233-2369
NPI assigned
Aug 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Daniel Mario Antonino, PT, OCSNPI 1275615916
Title
Owner, Ceo, Secretary
Phone
(702) 233-3288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 0669 NV Primary

Addresses

Primary practice location

7955 W Sahara Ave
Suite #103
Las Vegas, NV 89117-7910

Mailing address

7955 W Sahara Ave
Suite #103
Las Vegas, NV 89117-7910
Phone (702) 233-3288

Other names 1

  • Performance Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406001846 NV Part B Supplier - Clinic/Group Practice 8325031172 Receives reassigned benefits from 3 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

7955 W Sahara Ave
Ste 103
Las Vegas, NV 89117
Phone (702) 233-3288

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1306030622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7955 W SAHARA AVE",
            "address_2": "SUITE #103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177910",
            "telephone_number": "702-233-3288",
            "fax_number": "702-233-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7955 W SAHARA AVE",
            "address_2": "SUITE #103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177910",
            "telephone_number": "702-233-3288",
            "fax_number": "702-233-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL M. ANTONINO PROF. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "ANTONINO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "MARIO",
        "authorized_official_title_or_position": "OWNER, CEO, SECRETARY",
        "authorized_official_telephone_number": "702-233-3288",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, OCS"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NV",
            "license": "0669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.