Active NPI
Hayden Elizabeth Decillis, MSPT
- Physical Therapist
- Bronxville, NY
National Provider Identifier
1396981585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 020442-1
- Practice address
- 205 Pondfield Rd W
Bronxville, NY 10708-1010 - Phone
- (917) 375-3397
- NPI assigned
- Dec 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 020442-1 | NY | Primary |
Addresses
Primary practice location
205 Pondfield Rd W
Bronxville, NY 10708-1010
Mailing address
205 Pondfield Rd W
Bronxville, NY 10708-1010
Phone (917) 375-3397
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020442-1 | Other | NY | NEW YORK STATE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020442-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640649600000",
"number": "1396981585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 PONDFIELD RD W",
"city": "BRONXVILLE",
"state": "NY",
"postal_code": "107081010",
"telephone_number": "917-375-3397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 PONDFIELD RD W",
"city": "BRONXVILLE",
"state": "NY",
"postal_code": "107081010",
"telephone_number": "917-375-3397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECILLIS",
"first_name": "HAYDEN",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-18",
"last_updated": "2021-12-28",
"certification_date": "2021-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "020442-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE",
"identifier": "020442-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronxville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.