Joanna Paula Ibaos Semanero

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

63170 Issued in OR

Practice address

1620 Ohm Ave
Bronx, NY 10465-1017

Phone

(315) 237-7121

NPI assigned

Sep 14, 2018

Last updated

Oct 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1396229324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10022 SE 172ND AVE",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970869630",
            "telephone_number": "917-859-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 OHM AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651017",
            "telephone_number": "315-237-7121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10022 SE 172nd Ave",
            "address_purpose": "LOCATION",
            "city": "Happy Valley",
            "state": "OR",
            "postal_code": "970869630",
            "country_code": "US",
            "telephone_number": "917-859-3631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEMANERO",
        "first_name": "JOANNA PAULA",
        "middle_name": "IBAOS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040632",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HappyValley",
            "affiliation": "N",
            "address_1": "10022 SE 172nd Ave",
            "city": "Happy Valley",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970869630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Bronx, NY
• Providers in Bronx, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.