Individual provider Active NPI

Vito Anthony Genova, D.P.T.

  • Physical Therapist
  • Bayside, NY
National Provider Identifier
1306288089
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
033011-1 Issued in NY
Practice address
4562 Bell Blvd
Bayside, NY 11361-3355
Phone
(718) 281-2861
Fax
(718) 281-0173
NPI assigned
Jul 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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 033011-1 NY Primary

Addresses

Primary practice location

4562 Bell Blvd
Bayside, NY 11361-3355

Mailing address

994 Southern Dr
Franklin Square, NY 11010-1020

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

LicenseStateTypeSpecialty
033011-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas J. Mata Ssa, P.T., P.C. PastSince Jan 1, 2009 Accepting new patients
David Nupp, P.T., P.C. Past Accepting new patients

Organizations & group practices 2

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": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1306288089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 SOUTHERN DR",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110101020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4562 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613355",
            "telephone_number": "718-281-2861",
            "fax_number": "718-281-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENOVA",
        "first_name": "VITO",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033011-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.

Verify at the official NPI Registry.