Individual provider Active NPI

Jennifer Sepulveda, P.T.

  • Pediatric Physical Therapist
  • Bronx, NY
National Provider Identifier
1487887535
Registry record updated Aug 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
025318 Issued in NY
Practice address
2904 Bruckner Blvd
Bronx, NY 10465-2101
Phone
(347) 582-2534
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 025318 NY Primary

Addresses

Primary practice location

2904 Bruckner Blvd
Bronx, NY 10465-2101

Mailing address

2904 Bruckner Blvd
Bronx, NY 10465-2101

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
025318NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Physical & PastSince Jan 1, 2006 Accepting new patients
Prohealth Care Associates, LLP Past Accepting new patients

Organizations & group practices 2

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": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251072000000",
    "number": "1487887535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 BRUCKNER BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104652101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 BRUCKNER BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104652101",
            "telephone_number": "347-582-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPULVEDA",
        "first_name": "JENNIFER",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "025318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.