Individual provider Active NPI

Kenan Trebincevic, MSPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1679598593
Registry record updated Jul 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028312 Issued in NY
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

Updated by the provider on Jul 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
14.007695CTMDPhysical Therapist
028312NYMDPhysician 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.

Verify at the official NPI Registry.