Individual provider Active NPI

Fabricio Passos Rodrigues, MSPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1306176870
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
029870-1 Issued in NY
Practice address
1968 7TH Ave
Apt 3B
New York, NY 10026-1726
Phone
(917) 703-2044
NPI assigned
Jan 6, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 029870-1 NY Primary

Addresses

Primary practice location

1968 7TH Ave
Apt 3B
New York, NY 10026-1726

Mailing address

1968 7TH Ave
Apt 3B
New York, NY 10026-1726
Phone (917) 703-2044

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100204000293 NY Practitioner - Physical Therapist in Private Practice 7618010299 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

430 W 24TH St
Suite 1F
New York, NY 10011-1328
Phone (212) 741-5544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029870-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bounce Back Physical Therapy, PC CurrentSince Apr 21, 2017 Accepting new patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist CurrentSince Apr 1, 2015 Accepting new patients
Physical Therapy and Chiropractic PLLC Physical Therapist CurrentSince Nov 24, 2014 Accepting new patients

Locations

10814 72nd Ave
Ste 4
Forest Hills, NY 11375
Phone (718) 749-2171

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

430 W 24th St
Apt 1F
New York, NY 10011
Phone (212) 741-5544

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1306176870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1968 7TH AVE",
            "address_2": "APT 3B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261726",
            "telephone_number": "917-703-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 7TH AVE",
            "address_2": "APT 3B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261726",
            "telephone_number": "917-703-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUES",
        "first_name": "FABRICIO",
        "middle_name": "PASSOS",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029870-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.