Individual provider Active NPI

Dennis Guevarra Lumawig, RPT

  • Specialist
  • New York, NY
National Provider Identifier
1326375007
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
28546-1 Issued in NY
Practice address
460 Grand St
New York, NY 10002-4058
Phone
(212) 539-0257
Fax
(212) 677-4853
NPI assigned
Nov 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 28546-1 NY Primary

Addresses

Primary practice location

460 Grand St
New York, NY 10002-4058

Mailing address

460 Grand St
New York, NY 10002-4058
Phone (212) 539-0257

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
28546-1NYMDSpecialist
028546NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1326375007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 GRAND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024058",
            "telephone_number": "212-539-0257",
            "fax_number": "212-677-4853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 GRAND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024058",
            "telephone_number": "212-539-0257",
            "fax_number": "212-677-4853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMAWIG",
        "first_name": "DENNIS",
        "middle_name": "GUEVARRA",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-17",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "28546-1",
            "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 Nov 17, 2009; 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.