Individual provider Active NPI

Paula Andrea Hurtado Rengifo, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1336836071
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
050228 Issued in NY
Practice address
139 E 57TH St FL 2ND and 3Rd Floor
New York, NY 10022-2102
Phone
(212) 753-4767
Fax
(212) 753-4076
NPI assigned
Apr 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 050228 NY Primary

Addresses

Primary practice location

139 E 57TH St FL 2ND and 3Rd Floor
New York, NY 10022-2102

Mailing address

1255 5TH Ave
Suite 6L
New York, NY 10029
Phone (914) 400-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230501002777 NY Practitioner - Physical Therapist in Private Practice 9436514262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1910 S Rd
Poughkeepsie, NY 12601-6027
Phone (845) 454-0120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050228NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Single Specialty CurrentSince Sep 13, 2024 Accepting new patients
Health Sos PT PC Single Specialty CurrentSince Apr 15, 2023 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Sep 13, 2024 Accepting new patients

Locations

1 Hanson Pl
Brooklyn, NY 11243
Phone (718) 783-0934

550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737

139 E 57th St
Fl 23
New York, NY 10022

139 E 57th St
Fl 2
New York, NY 10022
Phone (212) 203-2813

139 E 57th St
New York, NY 10022
Phone (212) 753-4767

1255 5th Ave
Apt 6L
New York, NY 10029
Phone (914) 390-0080

1910 South Rd
Poughkeepsie, NY 12601
Phone (845) 454-0120

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": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1336836071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 5TH AVE",
            "address_2": "SUITE 6L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "914-400-1500",
            "fax_number": "914-478-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 E 57TH ST FL 2ND AND 3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222102",
            "telephone_number": "212-753-4767",
            "fax_number": "212-753-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURTADO RENGIFO",
        "first_name": "PAULA",
        "middle_name": "ANDREA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-21",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050228",
            "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 Feb 2, 2024; 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.