Enida Tatarevic, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

035050 Issued in NY

Practice address

1 New Hampshire Ave
Troy, NY 12180-1754

Phone

(518) 273-2121

Fax

(518) 273-0701

NPI assigned

Aug 15, 2012

Last updated

Dec 12, 2012By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Maccio Physcial Therapy PLLC

  • Physical Therapy Clinic/Center
  • Troy, NY
  • NPI 1093705535
  NPD (past)

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1720336266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 COSBY RD",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135021418",
            "telephone_number": "315-269-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NEW HAMPSHIRE AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121801754",
            "telephone_number": "518-273-2121",
            "fax_number": "518-273-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATAREVIC",
        "first_name": "ENIDA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jihong Tang, MD
• Elena Marie Tanski, MHC
• Casey Lynn Tarbell, M.S. SLP
• Barbara J Tashjian, NP
• Andrea Tata
• Jennifer Tavani, OTR/L
• Melissa Taylor, SLP
• Jo Ann Tedeschi, PA
• Emily Grace Teeter, PA-C
• The Eliot at Troy LLC

• Physical Therapist in Troy, NY
• Providers in Troy, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.