Individual provider Active NPI

Gracita Tatiana Charles, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1376798942
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026870-1 Issued in NY
Practice address
109 8TH Ave Apt 4F
Brooklyn, NY 11215-1515
Phone
(347) 436-6430
NPI assigned
Nov 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

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 026870-1 NY Primary

Addresses

Primary practice location

109 8TH Ave Apt 4F
Brooklyn, NY 11215-1515

Mailing address

109 8TH Ave Apt 4F
Brooklyn, NY 11215-1515
Phone (347) 436-6430

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210517001716 NY Practitioner - Physical Therapist in Private Practice 1557770880 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026870NYMDGeneral Practice Dentistry
026870-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth and Fitness PT OT PLLC Physical Therapist CurrentSince Feb 12, 2021 Accepting new patients
Prohealth and Fitness PT OT PLLC Physical Therapist CurrentSince Feb 12, 2021 Accepting new patients
Integrative Physical Therapy Wellness, PLLC Physical Therapist CurrentSince Jun 1, 2024 Accepting new patients
Integrative Physical Therapy, PLLC Physical Therapist CurrentSince May 14, 2023 Accepting new patients

Locations

1 Barney Rd
Ste 120
Clifton Park, NY 12065
Phone (518) 373-0735

150 W End Ave
Apt 1M
New York, NY 10023
Phone (212) 496-2600

Organizations & group practices 4

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": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1376798942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 8TH AVE APT 4F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112151515",
            "telephone_number": "347-436-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 8TH AVE APT 4F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112151515",
            "telephone_number": "347-436-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "GRACITA",
        "middle_name": "TATIANA",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026870-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 24, 2008; 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.