Active NPI
Daniel Rodriguez Jr., MT
- Massage Therapist
- Staten Island, NY
National Provider Identifier
1366045072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 027821
- Practice address
- 464 Manor Rd
Staten Island, NY 10314-2956 - Phone
- (718) 442-6690
- NPI assigned
- Nov 17, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 027821 | NY | Primary |
Addresses
Primary practice location
464 Manor Rd
Staten Island, NY 10314-2956
Mailing address
7700 Amboy Rd
Staten Island, NY 10307-1434
Phone (718) 208-0683
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)
- Not enrolled
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027821 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1366045072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7700 AMBOY RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103071434",
"telephone_number": "718-208-0683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "464 MANOR RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103142956",
"telephone_number": "718-442-6690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "DANIEL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-17",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "027821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.