Individual provider Active NPI

Edison Guzman

  • Physical Therapy Assistant
  • Philadelphia, PA
National Provider Identifier
1497295950
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TE011237 Issued in PA
Practice address
133 W Hunting Park Ave
Philadelphia, PA 19140-2717
Phone
(215) 455-5370
Fax
(215) 455-5374
NPI assigned
Mar 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE011237 PA Primary

Addresses

Primary practice location

133 W Hunting Park Ave
Philadelphia, PA 19140-2717

Mailing address

133 W Hunting Park Ave
Philadelphia, PA 19140-2717

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1497295950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402717",
            "telephone_number": "215-455-5370",
            "fax_number": "215-455-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "EDISON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-03",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE011237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; 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.