Individual provider Active NPI

John Fulton, P.T.

  • Physical Therapist
  • Wappingers Falls, NY
National Provider Identifier
1427039809
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
019159 Issued in NY
Practice address
2 Delavergne Ave
C/O Center for Physical Therapy
Wappingers Falls, NY 12590-1202
Phone
(845) 297-4789
Fax
(845) 297-8596
NPI assigned
Nov 11, 2005
Last updated
May 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2010

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 019159 NY Primary

Addresses

Primary practice location

2 Delavergne Ave
C/O Center for Physical Therapy
Wappingers Falls, NY 12590-1202

Mailing address

2 Delavergne Ave
C/O Center for Physical Therapy
Wappingers Falls, NY 12590-1202
Phone (845) 297-4789

Other identifiers 10

IdentifierTypeStateIssuer
2276723OtherUNITED HEALTH CARE
7542427OtherAETNA PPO
P3106209OtherOXFORD
3102929OtherAETNA HMO
807052OtherMANAGED PHYSICAL NETWORK
Q5081OtherNYBLUE CROSS BLUE SHIELD
000409357001OtherHEALTH NOW
713697OtherMVP
83399OtherOPERATING ENGNRS LCL 825
2162486OtherCCN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040603000633 NY Practitioner - Physical Therapist in Private Practice 2466434469 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019159NYMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy of New York, P.C. Physical Therapist PastSince Dec 6, 2017 Accepting new patients

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, 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": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1427039809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DELAVERGNE AVE",
            "address_2": "C/O CENTER FOR PHYSICAL THERAPY",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125901202",
            "telephone_number": "845-297-4789",
            "fax_number": "845-297-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DELAVERGNE AVE",
            "address_2": "C/O CENTER FOR PHYSICAL THERAPY",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125901202",
            "telephone_number": "845-297-4789",
            "fax_number": "845-297-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "019159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2276723",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7542427",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3106209",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3102929",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED PHYSICAL NETWORK",
            "identifier": "807052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Q5081",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000409357001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "713697",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPERATING ENGNRS LCL 825",
            "identifier": "83399",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "2162486",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wappingers Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.