Individual provider Active NPI

Claudia S Flobil Heredia, PT,DPT

  • Physical Therapist
  • Johnston, RI
National Provider Identifier
1568045771
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT03498 Issued in RI
Practice address
1412 Atwood Ave
Johnston, RI 02919-4821
Phone
(401) 213-8799
NPI assigned
May 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 047039-1 NY
Physical Therapist 225100000X PT03498 RI Primary

Addresses

Primary practice location

1412 Atwood Ave
Johnston, RI 02919-4821

Mailing address

1412 Atwood Ave
Johnston, RI 02919-4821
Phone (401) 213-8799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221024001723 RI Practitioner - Physical Therapist in Private Practice 1557760576 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047039-1NYMDPhysical Therapist
PT03498RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Physical Therapy, LLC Physical Therapist CurrentSince Nov 1, 2022 Accepting new patients

Locations

1412 Atwood Ave
Johnston, RI 02919
Phone (401) 213-8799

535 Centerville Rd
Ste 101
Warwick, RI 02886
Phone (401) 737-4581

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, 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": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1568045771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 ATWOOD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029194821",
            "telephone_number": "401-213-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 ATWOOD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029194821",
            "telephone_number": "401-213-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOBIL HEREDIA",
        "first_name": "CLAUDIA",
        "middle_name": "S",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047039-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT03498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.