Individual provider Active NPI

Johny Ackamparambil Cyriac

  • Physical Therapy Assistant
  • Glen Oaks, NY
National Provider Identifier
1669122131
Registry record updated Mar 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
005943 Issued in NY
Practice address
8264 268TH St
Glen Oaks, NY 11004-1562
Phone
(718) 344-8666
NPI assigned
Mar 26, 2022
Last updated
Mar 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 005943 NY Primary

Addresses

Primary practice location

8264 268TH St
Glen Oaks, NY 11004-1562

Mailing address

8264 268TH St
Glen Oaks, NY 11004-1562
Phone (718) 344-8666

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

NPI Registry JSON

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648252800000",
    "number": "1669122131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8264 268TH ST",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041562",
            "telephone_number": "718-344-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8264 268TH ST",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041562",
            "telephone_number": "718-344-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYRIAC",
        "first_name": "JOHNY",
        "middle_name": "ACKAMPARAMBIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-26",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "005943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Oaks, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; 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.