Ronaldo San Juan Corachea

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

018679-1 Issued in NY

Practice address

7608 69TH PL Apt 2B
Glendale, NY 11385-7138

Phone

(347) 886-6661

NPI assigned

Jun 22, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimum Therapeutics PT and OT PLLCGroup PAC ID 5991977712, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Optimum Therapeutics PT & OT PLLC

  • Physical Therapist
  • Melville, NY
  • NPI 1972882322
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1669793980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7608 69TH PL APT 2B",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857138",
            "telephone_number": "347-886-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7608 69TH PL APT 2B",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857138",
            "telephone_number": "347-886-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORACHEA",
        "first_name": "RONALDO",
        "middle_name": "SAN JUAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "018679-1",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "018679-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luz Maria Colon, SA-C
• Stacey Como, LPN
• Comprehensive Women's Health of N.Y. PLLC
• Contacts and Optical LTD.
• Makenzi Cooley, LMFT
• Gina Lucia Corniello, MS.ED
• Cosmetic & Surgical Arts, LLC
• Enza Cottone
• Gloria Crespo, HHA, CNA
• Uriel Cruz

• Geriatric Physical Therapist in Glendale, NY
• Providers in Glendale, NY by specialty
• Geriatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.