Individual provider Active NPI

Mary Grace Aguipo Tito

  • Physical Therapist
  • New York, NY
National Provider Identifier
1679254437
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045012 Issued in NY
Practice address
1345 Avenue of the Americas FL 15
New York, NY 10105-0021
Phone
(212) 981-1977
NPI assigned
Jul 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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 045012 NY Primary

Addresses

Primary practice location

1345 Avenue of the Americas FL 15
New York, NY 10105-0021

Mailing address

14329 Funston Ave
Norwalk, CA 90650-4943
Phone (562) 584-5962

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

State licenses

LicenseStateTypeSpecialty
045012NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1679254437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14329 FUNSTON AVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504943",
            "telephone_number": "562-584-5962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 AVENUE OF THE AMERICAS FL 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101050021",
            "telephone_number": "212-981-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITO",
        "first_name": "MARY GRACE",
        "middle_name": "AGUIPO",
        "name_prefix": "Prof.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045012",
            "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 Jul 26, 2023; 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.