Individual provider Active NPI

Lucille Catherine Opazo

  • Massage Therapist
  • Brooklyn, NY
National Provider Identifier
1376268359
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
032619 Issued in NY
Practice address
1497 Carroll St Apt 37
Brooklyn, NY 11213-4540
Phone
(561) 676-7855
NPI assigned
Oct 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 032619 NY Primary

Addresses

Primary practice location

1497 Carroll St Apt 37
Brooklyn, NY 11213-4540

Mailing address

1497 Carroll St Apt 37
Brooklyn, NY 11213-4540
Phone (561) 676-7855

Other identifiers 1

IdentifierTypeStateIssuer
WU42647FMedicaidNY

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1376268359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1497 CARROLL ST APT 37",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112134540",
            "telephone_number": "561-676-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 CARROLL ST APT 37",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112134540",
            "telephone_number": "561-676-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPAZO",
        "first_name": "LUCILLE",
        "middle_name": "CATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "032619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WU42647F",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.