Individual provider Active NPI

Jose Vince Ambion, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1679284434
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045665 Issued in NY
Practice address
708 W 177TH St Ste 4
New York, NY 10033-6929
Phone
(646) 360-3879
Fax
(646) 360-3892
NPI assigned
Dec 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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 045665 NY Primary

Addresses

Primary practice location

708 W 177TH St Ste 4
New York, NY 10033-6929

Mailing address

708 W 177TH St Ste 4
New York, NY 10033-6929
Phone (646) 360-3879

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.evergreenptny.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
88.31
Improvement activities
40
Cost
69.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045665NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Physical Therapy PC Physical Therapist CurrentSince Dec 18, 2022 Accepting new patients

Locations

708 W 177th St
Ste 4
New York, NY 10033
Phone (646) 360-3879

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": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1679284434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 W 177TH ST STE 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336929",
            "telephone_number": "646-360-3879",
            "fax_number": "646-360-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 W 177TH ST STE 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336929",
            "telephone_number": "646-360-3879",
            "fax_number": "646-360-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBION",
        "first_name": "JOSE VINCE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.evergreenptny.com",
            "affiliation": "N",
            "address_1": "708 W 177th St Ste 4",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100336929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.