Active NPI
Robert Depeppo, STUDENT PT
- Physical Therapist
- Staten Island, NY
National Provider Identifier
1447946181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 051459-01
- Practice address
- 1492 Victory Blvd
Staten Island, NY 10301-3910 - Phone
- (718) 720-2288
- Fax
- (718) 720-5444
- NPI assigned
- Apr 14, 2023
- Sex
- Male
- 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 | 051459-01 | NY | Primary |
Addresses
Primary practice location
1492 Victory Blvd
Staten Island, NY 10301-3910
Mailing address
371 Bryson Ave
Staten Island, NY 10314-1924
Phone (347) 552-2762
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 |
|---|---|---|---|
| 051459-01 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Procare Wellness Center LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Staten Island, NY
- NPI 1053844134
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770336000000",
"number": "1447946181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "371 BRYSON AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103141924",
"telephone_number": "347-552-2762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1492 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103013910",
"telephone_number": "718-720-2288",
"fax_number": "718-720-5444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEPEPPO",
"first_name": "ROBERT",
"credential": "STUDENT PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-14",
"last_updated": "2026-02-06",
"certification_date": "2026-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "051459-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.