Individual provider Active NPI

Ma Syvil Gulle Sombrio

  • Physical Therapist
  • New York, NY
National Provider Identifier
1366762163
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
029276-1 Issued in NY
Practice address
575 8TH Ave FL 6
New York, NY 10018-3158
Phone
(917) 286-5317
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 029276-1 NY Primary

Addresses

Primary practice location

575 8TH Ave FL 6
New York, NY 10018-3158

Mailing address

575 8TH Ave FL 6
New York, NY 10018-3158
Phone (917) 286-5317

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170310000083 NJ Practitioner - Physical Therapist in Private Practice 5890079891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ec Kinetic Physical Therapy LLCGroup PAC ID 1052695616, 3 clinicians

Practice addresses (Care Compare)

120 E Halsey Rd
Parsippany, NJ 07054-3720
Phone (973) 794-3080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029276-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ec Kinetic Physical Therapy, LLC Physical Therapist CurrentSince Oct 18, 2021 Accepting new patients
Ecam Therapy Services, LLC Physical Therapist PastSince Jan 16, 2016 Accepting new patients

Locations

120 E Halsey Rd
Parsippany, NJ 07054
Phone (201) 667-6971

Organizations & group practices 2

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1366762163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 8TH AVE FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183158",
            "telephone_number": "917-286-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 8TH AVE FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183158",
            "telephone_number": "917-286-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMBRIO",
        "first_name": "MA SYVIL",
        "middle_name": "GULLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029276-1",
            "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 Jun 3, 2010; 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.