Active NPI
Marck Santiago, PHYSICAL THERAPIST
- Specialist
- Rego Park, NY
National Provider Identifier
1629238076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 026283
- Practice address
- 9785 Queens Blvd
Rego Park, NY 11374-3319 - Phone
- (718) 261-9100
- NPI assigned
- Jun 10, 2008
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 026283 | NY | Primary |
Addresses
Primary practice location
9785 Queens Blvd
Rego Park, NY 11374-3319
Mailing address
9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100
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
| License | State | Type | Specialty |
|---|---|---|---|
| 026283 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott Physical Therapy P.C. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Brooklyn, NY
- NPI 1841270923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213056000000",
"number": "1629238076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9785 QUEENS BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113743319",
"telephone_number": "718-261-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9785 QUEENS BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113743319",
"telephone_number": "718-261-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "MARCK",
"name_prefix": "Mr.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-10",
"last_updated": "2008-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "026283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.