Individual provider Active NPI

Henler Datu Tahil, PT, DPT

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1518204072
Registry record updated Dec 31, 2020
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.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
030678-1 Issued in NY
Practice address
4055 College Point Blvd
Flushing, NY 11354-5169
Phone
(917) 355-7522
NPI assigned
Jan 3, 2013
Last updated
Dec 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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 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. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
030678-1NYMDPhysical Therapist
030678NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist PastSince Oct 16, 2009 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.

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

Verify at the official NPI Registry.