Giancarlo De Jesus, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1193940 Issued in TX

Practice address

112 Mustang Run
Boerne, TX 78006-1953

Phone

(516) 506-8273

NPI assigned

Jan 14, 2015

Last updated

Jan 14, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synergy Care Southeast LLCGroup PAC ID 6204079163, 193 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Synergy Care Southeast, LLC

  dba Synergy Care Southeast LLC - Texas

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1427466614

  TX

  Medicare reassignment Care Compare group NPD
• Legacy Healthcare Services Inc.

  • Physical Therapist
  • Cedar Park, TX
  • NPI 1871132357
  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1700275690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MUSTANG RUN",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780061953",
            "telephone_number": "516-506-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MUSTANG RUN",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780061953",
            "telephone_number": "516-506-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "GIANCARLO",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1193940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David J Katrana DDS,MD,PA
• Delana Rondrici Davis, LCSW
• Rachel Davis
• Eric Randell Day, A.T.C., L.A.T.
• Morgan Lee Day
• Avery Kristie De la Pena, MSOT, OTR
• Ricardo De la Pena, RBT
• Jesenia Christiann De Leon
• Melanie Vela De Leon, PHARMD
• Karen Becker Deanda, PHARMD

• Physical Therapist in Boerne, TX
• Providers in Boerne, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.