Individual provider Active NPI

Daniella Jean Buntog Da Jose, DPT

  • Physical Medicine & Rehabilitation Physician
  • Bronx, NY
National Provider Identifier
1699527713
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
044317 Issued in NY
Practice address
3409 Tibbett Ave
Bronx, NY 10463-3708
Phone
(929) 536-5542
NPI assigned
Apr 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 044317 NY Primary

Addresses

Primary practice location

3409 Tibbett Ave
Bronx, NY 10463-3708

Mailing address

3409 Tibbett Ave
Bronx, NY 10463-3708
Phone (929) 536-5542

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
044317NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1699527713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 TIBBETT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104633708",
            "telephone_number": "929-536-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 TIBBETT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104633708",
            "telephone_number": "929-536-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DA JOSE",
        "first_name": "DANIELLA JEAN",
        "middle_name": "BUNTOG",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "044317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.