Individual provider Active NPI

Enrique Carlos Jinete, DPT

  • Physical Therapist
  • Port Chester, NY
National Provider Identifier
1417063405
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
024127 Issued in NY
Practice address
30 N Main St
Suite 2
Port Chester, NY 10573-4256
Phone
(914) 939-3143
Fax
(914) 939-3120
NPI assigned
Aug 22, 2006
Last updated
Oct 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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 024127 NY Primary

Addresses

Primary practice location

30 N Main St
Suite 2
Port Chester, NY 10573-4256

Mailing address

30 N Main St
Suite 2
Port Chester, NY 10573-4256
Phone (917) 864-7706

Other identifiers 2

IdentifierTypeStateIssuer
02962334MedicaidNY
P00273417OtherNYRAILROAD CARRIER MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000450 NY Practitioner - Physical Therapist in Private Practice 7810960317 Reassigns benefits to 2 organizations
Practice locations: Port Chester, NY

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 N Main St
Suite 2
Port Chester, NY 10573-4257
Phone (914) 939-3143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Therapeutics Physical Therapy Part A, PLLC Physical Therapist CurrentSince Oct 7, 2010 Accepting new patients
Complete SLP, OT, PT & Psychology Services, PLLC CurrentSince Dec 1, 2025 Accepting new patients
Comprehensive OT, PT, SLP & Adult Health NP Services, PLLC Physical Therapist CurrentSince Aug 17, 2025 Accepting new patients

Locations

63 New Main St
Ste 1
Haverstraw, NY 10927
Phone (845) 290-9131

30 N Main St
Ste 2
Port Chester, NY 10573

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1417063405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MAIN ST",
            "address_2": "SUITE 2",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734256",
            "telephone_number": "917-864-7706",
            "fax_number": "914-939-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MAIN ST",
            "address_2": "SUITE 2",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734256",
            "telephone_number": "914-939-3143",
            "fax_number": "914-939-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JINETE",
        "first_name": "ENRIQUE",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02962334",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD CARRIER MEDICARE",
            "identifier": "P00273417",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.