Jericho Manaloto Ayson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0015793 Issued in CO

Practice address

18001 N. 79TH Ave
BLDG. 3 Suite A3
Glendale, AZ 85308

Phone

(623) 979-5266

Fax

(623) 776-9223

NPI assigned

Mar 17, 2008

Last updated

Aug 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Altura Hospice Services LLC

  • Community Based Hospice Care Agency
  • Albuquerque, NM
  • NPI 1700189958
  NPD (past)
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Greenville, NC
  • NPI 1932930153
  NPD (past)
• Beyondfaith Homecare & Rehab of Albuquerque LLC

  dba Compassus Home Health Albuquerque NM

  • Home Health Agency
  • Albuquerque, NM
  • NPI 1184665044
  NPD (past)

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1801067079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 N. 79TH AVE",
            "address_2": "BLDG, 3 SUITE A3",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "623-979-5266",
            "fax_number": "623-776-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 N. 79TH AVE",
            "address_2": "BLDG. 3 SUITE A3",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "623-979-5266",
            "fax_number": "623-776-9223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4308 Carlisle Blvd NE",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871074856",
            "country_code": "US",
            "telephone_number": "505-881-0425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYSON",
        "first_name": "JERICHO",
        "middle_name": "MANALOTO",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-17",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "3460",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0015793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.