NPIMap

Organization Active NPI

Big Leap Physical Therapy PC

  • Physical Disabilities Residential Treatment Facility
  • Woodside, NY
National Provider Identifier
1740685817
Registry record updated Nov 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
License
030854 Issued in NY
Legal business name
BIG LEAP PHYSICAL THERAPY PC
Practice address
3211 55TH St
Apt. 1
Woodside, NY 11377-1910
Phone
(646) 500-0607
NPI assigned
Oct 30, 2014
Last updated
Nov 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2014

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

Authorized official

Name
Ana Rheeda Del Mundo Aguilar, PT, DPTNPI 1770807877
Title
Doctor of Physical Therapy
Phone
(646) 500-0607

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X 030854 NY Primary

Addresses

Primary practice location

3211 55TH St
Apt. 1
Woodside, NY 11377-1910

Mailing address

3211 55TH St
Apt. 1
Woodside, NY 11377-1910
Phone (646) 500-0607

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150212000147 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8022333186 Receives reassigned benefits from 2 practitioners
Practice locations: Woodside, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415664000000",
    "number": "1740685817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 55TH ST",
            "address_2": "APT. 1",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771910",
            "telephone_number": "646-500-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 55TH ST",
            "address_2": "APT. 1",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771910",
            "telephone_number": "646-500-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG LEAP PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2014-11-11",
        "status": "A",
        "authorized_official_last_name": "AGUILAR",
        "authorized_official_first_name": "ANA RHEEDA",
        "authorized_official_middle_name": "DEL MUNDO",
        "authorized_official_title_or_position": "DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "646-500-0607",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NY",
            "license": "030854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; 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.