Individual provider Active NPI

Mimilanie Dayauon Barretto, PT

  • Physical Therapist
  • Hicksville, NY
National Provider Identifier
1316077308
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026519 Issued in NY
Practice address
111 West Old County Road
Unit 1, Lower Level
Hicksville, NY 11801-1180
Phone
(516) 433-4570
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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 026519 NY Primary

Addresses

Primary practice location

111 West Old County Road
Unit 1, Lower Level
Hicksville, NY 11801-1180

Mailing address

21 Tinder LN
Levittown, NY 11756-3452
Phone (718) 877-0535

Other practice location 1

2444 Walton Ave
Bronx, NY 10468-6407
Phone (718) 220-8293

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070814000761 NY Practitioner - Physical Therapist in Private Practice 5799876165 Reassigns benefits to 1 organization

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
Group practices
Home Physical Therapy Solutions P.C.Group PAC ID 0941340053, 6 clinicians

Practice addresses (Care Compare)

111 W Old Country Rd
Unit 1
Hicksville, NY 11801-4036
Phone (516) 433-4570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026519NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Physical Therapy Solutions P.C. Physical Therapist CurrentSince Sep 1, 2019 Accepting new patients
Greater New York Physical Therapy and Chiropractic PLLC Physical Therapist PastSince Mar 1, 2012 Accepting new patients
G. F.G Medical, P.C PastSince Oct 1, 1997 Accepting new patients
N.R. Medical, P.C Past Accepting new patients
Doctors United, Inc PastSince Oct 1, 1997 Accepting new patients
Bravo Occupational Therapy PC Physical Therapist PastSince Sep 1, 2019 Accepting new patients

Locations

111 W Old Country Rd
Ste 1
Hicksville, NY 11801
Phone (516) 433-4570

111 W Old Country Rd
Unit 1
Hicksville, NY 11801
Phone (516) 433-4570

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1316077308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 TINDER LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563452",
            "telephone_number": "718-877-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WEST OLD COUNTY ROAD",
            "address_2": "UNIT 1, LOWER LEVEL",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118011180",
            "telephone_number": "516-433-4570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2444 Walton Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104686407",
            "country_code": "US",
            "telephone_number": "718-220-8293",
            "fax_number": "718-220-8296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRETTO",
        "first_name": "MIMILANIE",
        "middle_name": "DAYAUON",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.