Individual provider Active NPI

Yesenia Acevedo

  • Physical Therapist
  • New York, NY
National Provider Identifier
1639935612
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
051339 Issued in NY
Practice address
552 6TH Ave
New York, NY 10011-2010
Phone
(212) 741-9288
NPI assigned
Feb 26, 2024
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 051339 NY Primary

Addresses

Primary practice location

552 6TH Ave
New York, NY 10011-2010

Mailing address

3 Huntington Quadrangle Ste 103N
Melville, NY 11747-4601
Phone (516) 474-2816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240507001532 NY Practitioner - Physical Therapist in Private Practice 0648610733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1776 Broadway
Suite 1220
New York, NY 10019-2007
Phone (212) 823-9730

44 Saint Marks PL
New York, NY 10003-8118
Phone (212) 529-5966

552 6TH Ave
New York, NY 10011-2010
Phone (212) 741-9288

552 Broadway
FL 4
New York, NY 10012-3922
Phone (212) 226-6704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051339NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Mar 25, 2024 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Mar 25, 2024 Accepting new patients

Locations

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

552 6th Ave
New York, NY 10011
Phone (212) 741-9288

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

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": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1639935612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HUNTINGTON QUADRANGLE STE 103N",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474601",
            "telephone_number": "516-474-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 6TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112010",
            "telephone_number": "212-741-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "YESENIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "051339",
            "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 Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.