Active NPI
Richard E Misiura, PT
- Physical Therapist
- New York, NY
National Provider Identifier
1619001823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 010624-1
- Practice address
- 30 E 60TH St RM 206
New York, NY 10022-7111 - Phone
- (212) 765-4800
- Fax
- (212) 765-4855
- NPI assigned
- Mar 16, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA00235000 | NJ | |
| Physical Therapist | 225100000X | 010624-1 | NY | Primary |
Addresses
Primary practice location
30 E 60TH St RM 206
New York, NY 10022-7111
Mailing address
30 E 60TH St RM 206
New York, NY 10022-7111
Phone (212) 765-4800
Other practice location 1
1907 Oak Tree Rd
Ste 203
Edison, NJ 08820-2070
Phone (732) 321-1855
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00235000 | NJ | MD | Physical Therapist |
| 010624 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1619001823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 E 60TH ST RM 206",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100227111",
"telephone_number": "212-765-4800",
"fax_number": "212-765-4855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E 60TH ST RM 206",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100227111",
"telephone_number": "212-765-4800",
"fax_number": "212-765-4855"
}
],
"practiceLocations": [
{
"address_1": "1907 Oak Tree Rd",
"address_2": "Ste 203",
"address_purpose": "LOCATION",
"city": "Edison",
"state": "NJ",
"postal_code": "088202070",
"country_code": "US",
"telephone_number": "732-321-1855",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MISIURA",
"first_name": "RICHARD",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00235000",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "010624-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.