Active NPI
Paolo Miguel Lebumfacil Dumadag, R.P.T.
- Physical Therapist
- Fort Wayne, IN
National Provider Identifier
1609074376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05008866A
- Practice address
- 2001 Hobson Rd
Fort Wayne, IN 46805-4872 - Phone
- (260) 484-9557
- NPI assigned
- Jul 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 05008866A | IN | Primary |
Addresses
Primary practice location
2001 Hobson Rd
Fort Wayne, IN 46805-4872
Mailing address
504 Cedar Glen Dr
Apt 4
Fort Wayne, IN 46825-6214
Phone (260) 416-6305
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05008866A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609074376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 CEDAR GLEN DR",
"address_2": "APT 4",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468256214",
"telephone_number": "260-416-6305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 HOBSON RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468054872",
"telephone_number": "260-484-9557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUMADAG",
"first_name": "PAOLO MIGUEL",
"middle_name": "LEBUMFACIL",
"credential": "R.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05008866A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.