Active NPI
Glenn Ernest Cabildo, PT
- Physical Therapist
- Bayside, NY
National Provider Identifier
1508190802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 020422
- Practice address
- 21316 39TH Ave
Bayside, NY 11361-2045 - Phone
- (718) 229-7800
- NPI assigned
- Sep 21, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 020422 | NY | Primary |
Addresses
Primary practice location
21316 39TH Ave
Bayside, NY 11361-2045
Mailing address
8015 41St Ave Apt 324
Elmhurst, NY 11373-1251
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 |
|---|---|---|---|
| 020422 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians Medical Rehabilitation Associates, PLLC | Past | 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.
-
- Physical Medicine & Rehabilitation Physician
- Bayside, NY
- NPI 1750468831
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253491200000",
"number": "1508190802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8015 41ST AVE APT 324",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21316 39TH AVE",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113612045",
"telephone_number": "718-229-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CABILDO",
"first_name": "GLENN",
"middle_name": "ERNEST",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-21",
"last_updated": "2009-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "020422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.