Individual provider Active NPI

Yesenia Ricardo Palomares, PTA

  • Physical Therapy Assistant
  • Miami, FL
National Provider Identifier
1457936775
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
30459 Issued in FL
Practice address
1890 SW 57TH Ave Ste 111
Miami, FL 33155-2164
Phone
(305) 262-1987
NPI assigned
Mar 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X 30459 FL Primary

Addresses

Primary practice location

1890 SW 57TH Ave Ste 111
Miami, FL 33155-2164

Mailing address

1900 SW 8TH St Apt W1009
Miami, FL 33135-3570
Phone (305) 785-4611

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

LicenseStateTypeSpecialty
30459FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Pro-Health Rehabilitation Center, Inc. PastSince Mar 21, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1457936775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SW 8TH ST APT W1009",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331353570",
            "telephone_number": "305-785-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 SW 57TH AVE STE 111",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331552164",
            "telephone_number": "305-262-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICARDO PALOMARES",
        "first_name": "YESENIA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "30459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.