Individual provider Active NPI

Bryan Dagaraga, PT

  • Physical Therapist
  • Yonkers, NY
National Provider Identifier
1649301318
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028391 Issued in NY
Practice address
340 S Broadway
Yonkers, NY 10705-2049
Phone
(914) 968-5125
Fax
(914) 968-5123
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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 028391 NY Primary

Addresses

Primary practice location

340 S Broadway
Yonkers, NY 10705-2049

Mailing address

174 Grand St
White Plains, NY 10601-4803
Phone (914) 328-8077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070807000562 NY Practitioner - Physical Therapist in Private Practice 1951492859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Medicine and Rehabilitation Center PAGroup PAC ID 1658273750, 26 clinicians

Practice addresses (Care Compare)

365 Route 304
Suite 102
Bardonia, NY 10954-1601
Phone (845) 624-2182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine and Rehabilitation Center PA Physical Therapist CurrentSince Aug 1, 2013 Accepting new patients

Locations

500 Grand Ave
Ste 100
Englewood, NJ 07631
Phone (201) 227-1760

365 Route 304
Ste 102
Nanuet, NY 10954
Phone (845) 624-2182

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1649301318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 GRAND ST",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014803",
            "telephone_number": "914-328-8077",
            "fax_number": "914-328-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107052049",
            "telephone_number": "914-968-5125",
            "fax_number": "914-968-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGARAGA",
        "first_name": "BRYAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.