Individual provider Active NPI

Angeline Mariz Armedilla Padua

  • Physical Therapist
  • Richmond Hill, NY
National Provider Identifier
1700614021
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045240-01 Issued in NY
Practice address
107-02R Jamaica Ave
Richmond Hill, NY 11418
Phone
(347) 829-3890
Fax
(347) 829-3888
NPI assigned
Jul 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 045240-01 NY Primary

Addresses

Primary practice location

107-02R Jamaica Ave
Richmond Hill, NY 11418

Mailing address

107-02R Jamaica Ave
Richmond Hill, NY 11418
Phone (347) 829-3890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925002612 NY Practitioner - Physical Therapist in Private Practice 9032650403 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045240-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
I Move Physical Therapy P.C Physical Therapist CurrentSince Oct 5, 2024 Accepting new patients
Physical Care PT PC Physical Therapist CurrentSince Jul 28, 2024 Accepting new patients
Barakat PT PC Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients
Move First Rehab PT, P.C PastSince Nov 24, 2024 Accepting new patients

Locations

631 Foster Ave
Brooklyn, NY 11230
Phone (718) 369-8200

2900 Bragg St
Brooklyn, NY 11235
Phone (718) 615-9500

5110 19th Ave
Brooklyn, NY 11204
Phone (718) 223-1800

242 Beach 20th St
Far Rockaway, NY 11691
Phone (718) 471-0982

6605 Dartmouth St
Rego Park, NY 11374

10702 Jamaica Ave
#R
Richmond Hill, NY 11418
Phone (347) 829-3840

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1700614021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107-02R JAMAICA AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "11418",
            "telephone_number": "347-829-3890",
            "fax_number": "347-829-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107-02R JAMAICA AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "11418",
            "telephone_number": "347-829-3890",
            "fax_number": "347-829-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADUA",
        "first_name": "ANGELINE MARIZ",
        "middle_name": "ARMEDILLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045240-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.