Individual provider Active NPI

Enrico Pasquarello, PT

  • Physical Therapist
  • Astoria, NY
National Provider Identifier
1669689709
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0285641-1 Issued in NY
Practice address
2307 30TH Dr Apt 1B
Astoria, NY 11102-3595
Phone
(646) 688-5200
Fax
(866) 925-8694
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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 0285641-1 NY Primary

Addresses

Primary practice location

2307 30TH Dr Apt 1B
Astoria, NY 11102-3595

Mailing address

255 Katan Ave
Staten Island, NY 10308-2268
Phone (347) 559-1745

Other practice location 1

132 W 31st St Ste 1533
New York, NY 10001-3406
Phone (646) 688-5200

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

LicenseStateTypeSpecialty
0285641-1NYMDPhysical Therapist
028564NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Life Care Planning LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1669689709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 KATAN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082268",
            "telephone_number": "347-559-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 30TH DR APT 1B",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111023595",
            "telephone_number": "646-688-5200",
            "fax_number": "866-925-8694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "132 W 31st St Ste 1533",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100013406",
            "country_code": "US",
            "telephone_number": "646-688-5200",
            "fax_number": "866-925-8694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASQUARELLO",
        "first_name": "ENRICO",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0285641-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.

Verify at the official NPI Registry.