Active NPI
Noel Eulogio Natividad, PT
- Physical Therapist
- Pine Grove, PA
National Provider Identifier
1750409363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT016277
- Practice address
- 918 Long Run Rd
Pine Grove, PA 17963-9020 - Phone
- (570) 739-2176
- NPI assigned
- Mar 26, 2007
- Last updated
- Jul 8, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT016277 | PA | Primary |
| Physical Therapist | 225100000X | 025322-1 | NY |
Addresses
Primary practice location
918 Long Run Rd
Pine Grove, PA 17963-9020
Mailing address
918 Long Run Rd
Pine Grove, PA 17963-9020
Phone (570) 739-2176
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025322-1 | NY | MD | Physical Therapist |
| PT016277 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750409363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "918 LONG RUN RD",
"city": "PINE GROVE",
"state": "PA",
"postal_code": "179639020",
"telephone_number": "570-739-2176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "918 LONG RUN RD",
"city": "PINE GROVE",
"state": "PA",
"postal_code": "179639020",
"telephone_number": "570-739-2176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NATIVIDAD",
"first_name": "NOEL",
"middle_name": "EULOGIO",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT016277",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "025322-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine Grove, PA
- Merakey Pennsylvania
- Francis Patrick Mohan, M.D.
- Charlene A Morgan, LPT
- Heather Lynn Morgan, MS, CCC-SLP
- Stephen D Muench, D.D.S.
- Phoenix Rehabilitation and Health Services, Inc
- Pine Grove Area School District
- Pine Grove Community Ambulance Association
- Janella Lynn Poda-Henry, LPC
- Courtney Evelyn Puglia, LSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.