Individual provider Active NPI

Martin Angelo Locsin, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1417701095
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
052190 Issued in NY
Practice address
18 6TH Ave
Brooklyn, NY 11217-4960
Phone
(646) 222-8995
NPI assigned
Apr 11, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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 052190 NY Primary

Addresses

Primary practice location

18 6TH Ave
Brooklyn, NY 11217-4960

Mailing address

2415 Church Ave Apt 202
Brooklyn, NY 11226-8440
Phone (703) 762-6174

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240606003065 NY Practitioner - Physical Therapist in Private Practice 9931641834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18 6TH Ave
Brooklyn, NY 11217-4960
Phone (646) 222-8995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
052190NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Spear Physical and Occupational Therapy, LLC Physical Therapist CurrentSince May 6, 2024 Accepting new patients
Radiology Associates of Main Street PC PastSince Apr 14, 2024 Accepting new patients

Locations

120 E 56th St
Rm 1010
New York, NY 10022
Phone (646) 790-7466

Organizations & group practices 2

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": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1417701095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 CHURCH AVE APT 202",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112268440",
            "telephone_number": "703-762-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 6TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112174960",
            "telephone_number": "646-222-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCSIN",
        "first_name": "MARTIN",
        "middle_name": "ANGELO",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052190",
            "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 Apr 11, 2024; 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.