Active NPI
Henler Datu Tahil, PT, DPT
- Physical Therapist
- Flushing, NY
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jun 19, 2025.
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 030678-1
- Practice address
- 4055 College Point Blvd
Flushing, NY 11354-5169 - Phone
- (917) 355-7522
- NPI assigned
- Jan 3, 2013
- Last updated
- Dec 31, 2020
- 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 | 030678-1 | NY | Primary |
Addresses
Primary practice location
4055 College Point Blvd
Flushing, NY 11354-5169
Mailing address
1912 Lenox Ave
East Meadow, NY 11554-4053
Phone (917) 355-7522
Other practice location 1
8430 112th St
Richmond Hill, NY 11418-1334
Phone (917) 355-7522
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030678-1 | NY | MD | Physical Therapist |
| 030678 | NY | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC | Physical Therapist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- Flushing, NY
- NPI 1538780507
-
- Physical Therapist
- Great Neck, NY
- NPI 1841526399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609372800000",
"number": "1518204072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1912 LENOX AVE",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "115544053",
"telephone_number": "917-355-7522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4055 COLLEGE POINT BLVD",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113545169",
"telephone_number": "917-355-7522"
}
],
"practiceLocations": [
{
"address_1": "8430 112th St",
"address_purpose": "LOCATION",
"city": "Richmond Hill",
"state": "NY",
"postal_code": "114181334",
"country_code": "US",
"telephone_number": "917-355-7522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DATU TAHIL",
"first_name": "HENLER",
"name_prefix": "Mr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-03",
"last_updated": "2020-12-31",
"certification_date": "2020-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "030678-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.