NPIMap

Individual provider Active NPI

Jacky Mari Cervantes, PT, DPT

  • Physical Therapist
  • Yonkers, NY
National Provider Identifier
1457885295
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
038891 Issued in NY
Practice address
909 Midland Ave , Ground Floor
Yonkers, NY 10704
Phone
(845) 553-4607
NPI assigned
Apr 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X
Neurology Physical Therapist 2251N0400X
Physical Therapist 225100000X 038891 NY Primary

Addresses

Primary practice location

909 Midland Ave , Ground Floor
Yonkers, NY 10704

Mailing address

1333A North Ave
# 717
New Rochelle, NY 10804-2120
Phone (845) 553-4607

Other practice location 1

984 Morris Park Avenue
Bronx, NY 10462
Phone (171) 882-3767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180604001103 CT Practitioner - Physical Therapist in Private Practice 8628333176 Reassigns benefits to 1 organization
I20181005000589 NY Practitioner - Physical Therapist in Private Practice 8628333176 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038891NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rimisac Family Health NP PC CurrentSince Aug 9, 2020 Accepting new patients
Carecity PT PC Physical Therapist Current Accepting new patients
JMC Physical Therapy PC Physical Therapist Current Accepting new patients
Castle Care PT Chiropractic PLLC Physical Therapist Current Accepting new patients
Alleviate Spinal Pain Physical Therapy & Rehabilitation Past Accepting new patients

Locations

120 Benchley Pl
Frnt 2
Bronx, NY 10475
Phone (347) 843-7760

1333 North Ave
Ste A
New Rochelle, NY 10804
Phone (347) 618-8022

909 Midland Ave
Yonkers, NY 10704
Phone (914) 267-5847

Organizations & group practices 7

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1457885295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333A NORTH AVE",
            "address_2": "# 717",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108042120",
            "telephone_number": "845-553-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 MIDLAND AVE , GROUND FLOOR",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10704",
            "telephone_number": "845-553-4607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "984 Morris Park Avenue",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10462",
            "country_code": "US",
            "telephone_number": "171-882-3767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "JACKY MARI",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "038891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.