Individual provider Active NPI

Daniel Ray De Gracia Sindo, P.T., DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1578558425
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
017724 Issued in NY
Practice address
128-130 Brighton Beach Avenue
Suite 1, 3Rd Floor
Brooklyn, NY 11235-8372
Phone
(718) 996-1854
Fax
(718) 996-1694
NPI assigned
Sep 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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 017724 NY Primary

Addresses

Primary practice location

128-130 Brighton Beach Avenue
Suite 1, 3Rd Floor
Brooklyn, NY 11235-8372

Mailing address

128-130 Brighton Beach Avenue
Suite 1, 3Rd Floor
Brooklyn, NY 11235-8372
Phone (718) 996-1854

Other identifiers 10

IdentifierTypeStateIssuer
182224OtherELDERPLAN
4473457OtherCIGNA
0136977OtherGHI
205808184OtherMAGNACARE
P3740765OtherOXFORD
03000005OtherHEALTHNET
2517079OtherUNITED HEALTHCARE
205808184OtherMULTIPLAN
02657674MedicaidNY
205808184Other1199

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
017724NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Unlimited, 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.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1578558425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128-130 BRIGHTON BEACH AVENUE",
            "address_2": "SUITE 1, 3RD FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358372",
            "telephone_number": "718-996-1854",
            "fax_number": "718-996-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128-130 BRIGHTON BEACH AVENUE",
            "address_2": "SUITE 1, 3RD FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358372",
            "telephone_number": "718-996-1854",
            "fax_number": "718-996-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINDO",
        "first_name": "DANIEL RAY",
        "middle_name": "DE GRACIA",
        "name_prefix": "Dr.",
        "credential": "P.T., DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDERPLAN",
            "identifier": "182224",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4473457",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0136977",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGNACARE",
            "identifier": "205808184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3740765",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "03000005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2517079",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "205808184",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02657674",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1199",
            "identifier": "205808184",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.