Active NPI
Erwin K Buenaseda, PT
- Physical Therapist
- Wilmington, DE
National Provider Identifier
1700100336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- JI-0001072
- Practice address
- 2701 Kirkwood Hwy
Lower Level
Wilmington, DE 19805-4911 - Phone
- (302) 668-1768
- Fax
- (302) 668-1794
- NPI assigned
- Mar 25, 2010
- Last updated
- Jul 23, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | JI-0001072 | DE | Primary |
Addresses
Primary practice location
2701 Kirkwood Hwy
Lower Level
Wilmington, DE 19805-4911
Mailing address
1265 Wayne Ave Ste 308
119 Professional Building
Indiana, PA 15701-3501
Phone (724) 081-8095
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2449064 | Medicaid | MD | |
| 2155101 | Other | DE | HIGHMARK |
| 3775507000 | Other | DE | IBC |
| P01033496 | Other | DE | MEDIARE RR |
| 1700100336 | Medicaid | DE |
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 |
|---|---|---|---|
| JI-0001072 | DE | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437609600000",
"number": "1700100336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1265 WAYNE AVE STE 308",
"address_2": "119 PROFESSIONAL BUILDING",
"city": "INDIANA",
"state": "PA",
"postal_code": "157013501",
"telephone_number": "724-081-8095",
"fax_number": "724-801-8147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 KIRKWOOD HWY",
"address_2": "LOWER LEVEL",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198054911",
"telephone_number": "302-668-1768",
"fax_number": "302-668-1794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUENASEDA",
"first_name": "ERWIN",
"middle_name": "K",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-25",
"last_updated": "2015-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DE",
"license": "JI-0001072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2449064",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "2155101",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC",
"identifier": "3775507000",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDIARE RR",
"identifier": "P01033496",
"state": "DE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700100336",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.