Individual provider Active NPI

Martha C Anibal Sr., PT

  • Physical Therapist
  • Astoria, NY
National Provider Identifier
1477725174
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014965 Issued in NY
Practice address
31-09 Newtown Ave
Suite 211
Astoria, NY 11102
Phone
(718) 728-2277
Fax
(718) 728-6945
NPI assigned
Apr 2, 2008
Last updated
Apr 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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 014965 NY Primary

Addresses

Primary practice location

31-09 Newtown Ave
Suite 211
Astoria, NY 11102

Mailing address

31-09 Newtown Ave
Suite 211
Astoria, NY 11102
Phone (718) 728-2277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190627003294 NY Practitioner - Physical Therapist in Private Practice 1355481870 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014965NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Priority One Therapy PT OT SLP PLLC CurrentSince May 24, 2024 Accepting new patients
Theracare & Wellness Physical Therapy,P.C Current Accepting new patients

Locations

3109 Newtown Ave
Ste 211
Astoria, NY 11102
Phone (718) 728-2277

99 W Hawthorne Ave
Ste 210
Valley Stream, NY 11580
Phone (718) 305-1190

Organizations & group practices 3

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1477725174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31-09 NEWTOWN AVE",
            "address_2": "SUITE 211",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "718-728-2277",
            "fax_number": "718-728-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31-09 NEWTOWN AVE",
            "address_2": "SUITE 211",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "718-728-2277",
            "fax_number": "718-728-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANIBAL",
        "first_name": "MARTHA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "name_suffix": "Sr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "014965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.