Individual provider Active NPI

Jilliane Mari Roa Borje

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1407341936
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
042638 Issued in NY
Practice address
1685 E 5TH St Apt 1F
Brooklyn, NY 11230-6919
Phone
(646) 891-6235
Fax
(646) 891-6235
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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 042638 NY Primary

Addresses

Primary practice location

1685 E 5TH St Apt 1F
Brooklyn, NY 11230-6919

Mailing address

1685 E 5TH St Apt 1F
Brooklyn, NY 11230-6919
Phone (646) 891-6235

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240808003136 NY Practitioner - Physical Therapist in Private Practice 9830636752 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042638NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Homeside Rehab, PT, OT, SLP LLC Physical Therapist CurrentSince Oct 25, 2024 Accepting new patients
PT and OT for Senior Rehab at Home PLLC Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients
Core Physical Therapy Services PC Physical Therapist CurrentSince Jun 1, 2024 Accepting new patients

Locations

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

171 Kings Hwy
Brooklyn, NY 11223
Phone (877) 722-7700

8008 45th Ave
Ofc
Elmhurst, NY 11373

441 Route 306
Ste 2
Monsey, NY 10952
Phone (201) 952-4436

296 Route 59
Ste 1225
Suffern, NY 10901

Organizations & group practices 3

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1407341936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 E 5TH ST APT 1F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306919",
            "telephone_number": "646-891-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 E 5TH ST APT 1F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306919",
            "telephone_number": "646-891-6235",
            "fax_number": "646-891-6235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORJE",
        "first_name": "JILLIANE MARI",
        "middle_name": "ROA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042638",
            "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 Aug 11, 2025; 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.