Micah Camille Talusan Baluyot, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

25MT00229100 Issued in NJ

Practice address

325 Danforth Ave
Apt 1B
Jersey City, NJ 07305-1928

Phone

(551) 208-3763

NPI assigned

Sep 8, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1548717325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DANFORTH AVE",
            "address_2": "APT 1B",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073051928",
            "telephone_number": "551-208-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 DANFORTH AVE",
            "address_2": "APT 1B",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073051928",
            "telephone_number": "551-208-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALUYOT",
        "first_name": "MICAH CAMILLE",
        "middle_name": "TALUSAN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00229100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Annjo Moste Balbutin
• Shraddha Baldania
• Dhanmatie Baldeo-Dat
• Baldwin Physical Therapy, LLC
• Barjeta Balidemaj, DC
• Rona Mae Baluyut, OTR/L
• Ana Banchs, LCSW
• Nashira Banks
• Katrina S. Bantis, DO, MS
• Charina Bantugan, FNP-C

• Athletic Trainer in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.