Active NPI
Stella M Avena, PT
- Physical Therapist
- Rio Rancho, NM
National Provider Identifier
1346454832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3788
- Practice address
- 3715 Southern Blvd SE
Suite 1106
Rio Rancho, NM 87124-2080 - Phone
- (505) 462-6047
- Fax
- (212) 953-1353
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 011122 | NY | |
| Physical Therapist | 225100000X | 3788 | NM | Primary |
Addresses
Primary practice location
3715 Southern Blvd SE
Suite 1106
Rio Rancho, NM 87124-2080
Mailing address
3715 Southern Blvd SE
Rio Rancho, NM 87124
Phone (505) 462-6047
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
| License | State | Type | Specialty |
|---|---|---|---|
| 011122 | NY | MD | Occupational Therapy Assistant |
| 3788 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H&D Physical Therapy & Occupational Therapy PLLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- New York, NY
- NPI 1235174228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327363200000",
"number": "1346454832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3715 SOUTHERN BLVD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "87124",
"telephone_number": "505-462-6047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3715 SOUTHERN BLVD SE",
"address_2": "SUITE 1106",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871242080",
"telephone_number": "505-462-6047",
"fax_number": "212-953-1353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVENA",
"first_name": "STELLA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2012-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "011122",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "3788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.