Individual provider Active NPI

Carl Calabrese, DPT

  • Physical Therapist
  • Las Cruces, NM
National Provider Identifier
1366877425
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4830 Issued in NM
Practice address
2404 S Locust St
Ste 5
Las Cruces, NM 88001-5789
Phone
(575) 521-4188
Fax
(575) 521-3668
NPI assigned
Sep 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4830 NM Primary
Physical Therapist 225100000X 036413 NY

Addresses

Primary practice location

2404 S Locust St
Ste 5
Las Cruces, NM 88001-5789

Mailing address

2404 S Locust St
Ste 5
Las Cruces, NM 88001-5789
Phone (575) 521-4188

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131210001497 NY Practitioner - Physical Therapist in Private Practice 3173750585 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036413NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Physical Therapy LLC Physical Therapist CurrentSince Nov 20, 2013 Accepting new patients
Marc P Pietropaoli MD PC CurrentSince Sep 21, 2015 Accepting new patients
Real View Diagnostics LLC Physical Therapist PastSince Jul 18, 2016 Accepting new patients

Locations

791 W Genesee Street Rd
Skaneateles, NY 13152
Phone (315) 685-7544

1054 James St
Syracuse, NY 13203
Phone (315) 422-2912

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": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1366877425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 S LOCUST ST",
            "address_2": "STE 5",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015789",
            "telephone_number": "575-521-4188",
            "fax_number": "575-521-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 S LOCUST ST",
            "address_2": "STE 5",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015789",
            "telephone_number": "575-521-4188",
            "fax_number": "575-521-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "CARL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-09",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4830",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036413",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.