Active NPI
Michael Domenick Tenerelli, LMT
- Massage Therapist
- Kings Park, NY
National Provider Identifier
1467112912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 032715-01
- Practice address
- 10 Cortez LN
Kings Park, NY 11754-4518 - Phone
- (631) 379-3159
- NPI assigned
- Dec 26, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 032715-01 | NY | Primary |
Addresses
Primary practice location
10 Cortez LN
Kings Park, NY 11754-4518
Mailing address
10 Cortez LN
Kings Park, NY 11754-4518
Phone (631) 379-3159
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 |
|---|---|---|---|
| 032715-01 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Body Mind Spirit Massage Therapy PLLC | Single Specialty | Current | 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": "1640476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640476800000",
"number": "1467112912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CORTEZ LN",
"city": "KINGS PARK",
"state": "NY",
"postal_code": "117544518",
"telephone_number": "631-379-3159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CORTEZ LN",
"city": "KINGS PARK",
"state": "NY",
"postal_code": "117544518",
"telephone_number": "631-379-3159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TENERELLI",
"first_name": "MICHAEL",
"middle_name": "DOMENICK",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-26",
"last_updated": "2021-12-26",
"certification_date": "2021-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "NY",
"license": "032715-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kings Park, NY
- Suffolk County Foot Care PLLC
- Jane R Tanzi Afati
- Joseph John Tarantola, PHARMACIST
- Lawrence Eugene Taub, MSW
- Kenneth Louis Teape
- The Society of St. Johnland
- Think Nest Integrative Psychological Services, PLLC
- Melissa Marie Thomas, PMHNP
- Tina Christoffersen Therapy LCSW, P.C.
- Jennifer Linda Tong, M.S, CCC-SLP, TSSLD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.