Demetrio C Cabrera, P.T.

Primary specialty

SpecialistTaxonomy code 174400000X

License

022429-1 Issued in NY

Practice address

1766 Sunrise Hwy
Bay Shore, NY 11706-6010

Phone

(631) 666-4600

Fax

(631) 666-4605

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jose a. Gonzalez DC PC

  • Clinic/Center
  • Bay Shore, NY
  • NPI 1972815397
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1609958321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 ORCHID DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119515002",
            "telephone_number": "631-666-4600",
            "fax_number": "631-666-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1766 SUNRISE HWY",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066010",
            "telephone_number": "631-666-4600",
            "fax_number": "631-666-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "DEMETRIO",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "022429-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2582658",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathi Ann Byberg Flynn
• Daria Bystry
• C and C Ambulette Services Corp
• Debra Jeanne Cabot, P.N.P.
• Brenda Marissa Cabrera, CRNA
• Jenni Fernanda Cabrera
• Isabelle Alexandra Caggiano, FNP
• Jessie Caggiano
• Jaclyn Sarah Cahill, DPT
• Jodi Mary Cahill, MA CCC SLP

• Specialist in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.