Active NPI
Kenan Trebincevic, MSPT
- Physical Therapist
- New York, NY
National Provider Identifier
1679598593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 028312
- Practice address
- 115 W 45TH St Ste 301
301
New York, NY 10036-4005 - Phone
- (212) 300-5545
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 028312 | NY | Primary |
| Physical Therapist | 225100000X | 14.007695 | CT |
Addresses
Primary practice location
115 W 45TH St Ste 301
301
New York, NY 10036-4005
Mailing address
800 Post Rd
Suite 3a
Darien, CT 06820-4622
Phone (203) 422-0679
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14.007695 | CT | MD | Physical Therapist |
| 028312 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469750400000",
"number": "1679598593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 POST RD",
"address_2": "SUITE 3A",
"city": "DARIEN",
"state": "CT",
"postal_code": "068204622",
"telephone_number": "203-422-0679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W 45TH ST STE 301",
"address_2": "301",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100364005",
"telephone_number": "212-300-5545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREBINCEVIC",
"first_name": "KENAN",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2016-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "028312",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "14.007695",
"primary": false
}
],
"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 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.