Carmela Mae Q Patrimonio, PTA, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045251-01 Issued in NY

Practice address

737 Commack Rd
Brentwood, NY 11717-7407

Phone

(631) 388-7500

NPI assigned

Feb 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1644624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1316692973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 RICHARD AVE",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118011224",
            "telephone_number": "929-622-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 COMMACK RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117177407",
            "telephone_number": "631-388-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRIMONIO",
        "first_name": "CARMELA MAE",
        "middle_name": "Q",
        "credential": "PTA, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-12",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "012400-01",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045251-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Brentwood, NY
• Providers in Brentwood, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.