Individual provider Active NPI

John Louis Furtado, ATC

  • Physical Therapist
  • Princeton, NJ
National Provider Identifier
1679598650
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00690400 Issued in NJ
Practice address
Princeton University Dillon Gym A30
Princeton, NJ 08544-0001
Phone
(609) 258-3518
Fax
(609) 258-7045
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 25MT00072300 NJ
Physical Therapist 225100000X 40QA00690400 NJ Primary

Addresses

Primary practice location

Princeton University Dillon Gym A30
Princeton, NJ 08544-0001

Mailing address

16 Jackie Dr
Lawrenceville, NJ 08648-2108
Phone (609) 512-1559

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
40QA00690400NJMDPhysical Therapist
25MT00072300NJMDAthletic Trainer

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": "1391472000000",
    "number": "1679598650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 JACKIE DR",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482108",
            "telephone_number": "609-512-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PRINCETON UNIVERSITY DILLON GYM A30",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085440001",
            "telephone_number": "609-258-3518",
            "fax_number": "609-258-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FURTADO",
        "first_name": "JOHN",
        "middle_name": "LOUIS",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00072300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00690400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.