Trifecta Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

028622 Issued in NY

Legal business name

TRIFECTA PHYSICAL THERAPY PC

Practice address

1070 Havemeyer Ave
Bronx, NY 10462-5310

Phone

(909) 992-2152

Fax

(570) 729-7242

NPI assigned

Sep 22, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Roman Allan Samson Sotelo, PTNPI 1295059061

Title

PT/Owner

Phone

(909) 992-2152

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roman Allan Samson Sotelo, R.P.T.

  • Physical Therapist
  • Bronx, NY
  • NPI 1295059061
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536537600000",
    "number": "1396254249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 HOBART AVE APT 4A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104615245",
            "telephone_number": "909-992-2152",
            "fax_number": "570-729-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 HAVEMEYER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104625310",
            "telephone_number": "909-992-2152",
            "fax_number": "570-729-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIFECTA PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-22",
        "last_updated": "2018-09-10",
        "status": "A",
        "authorized_official_last_name": "SOTELO",
        "authorized_official_first_name": "ROMAN ALLAN",
        "authorized_official_middle_name": "SAMSON",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "909-992-2152",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE II",
            "identifier": "1396254249",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND NPI",
            "identifier": "1295059061",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Tricarico, RPH
• Olia Chern Tricot, D.D.S.
• Marita Triebsee, LMSW
• Joseph H Triebwasser, M.D.
• Nhuy Trieu
• Sandra M Triggs, MA
• Heleni Trihas, OTR/L
• Trinamco, Inc.
• Tanya Lee Tringali, CNM
• Natalie Trinh

• 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 Sep 10, 2018; 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.