Active NPI
Kevin Ponce Obate, RPT
- Physical Therapist
- Bronx, NY
National Provider Identifier
1700384328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 040114
- Practice address
- 1975 University Ave
Bronx, NY 10453 - Phone
- (718) 618-0052
- Fax
- (718) 618-0100
- NPI assigned
- Jan 29, 2018
- 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 | 040114 | NY | Primary |
Addresses
Primary practice location
1975 University Ave
Bronx, NY 10453
Mailing address
2685 University Ave Apt 44a
Bronx, NY 10468-3360
Phone (917) 861-7610
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 |
|---|---|---|---|
| 040114 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532044800000",
"number": "1700384328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2685 UNIVERSITY AVE APT 44A",
"city": "BRONX",
"state": "NY",
"postal_code": "104683360",
"telephone_number": "917-861-7610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1975 UNIVERSITY AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "10453",
"telephone_number": "718-618-0052",
"fax_number": "718-618-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBATE",
"first_name": "KEVIN",
"middle_name": "PONCE",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-29",
"last_updated": "2018-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "040114",
"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 Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.