Active NPI
Riche Baldovino
- Physical Therapist
- Teaneck, NJ
National Provider Identifier
1821374653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 62 023652
- Practice address
- 625 Tilden Ave
Teaneck, NJ 07666-1845 - Phone
- (646) 769-0469
- NPI assigned
- Oct 25, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 40QA01048100 | NJ | |
| Physical Therapist | 225100000X | 62 023652 | NY | Primary |
Addresses
Primary practice location
625 Tilden Ave
Teaneck, NJ 07666-1845
Mailing address
625 Tilden Ave
Teaneck, NJ 07666-1845
Phone (646) 769-0469
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 |
|---|---|---|---|
| 40QA01048100 | NJ | MD | Physical Therapist |
| 62 023652 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Medicine and Rehabilitation of Ny | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Bronx, NY
- NPI 1528191830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319500800000",
"number": "1821374653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 TILDEN AVE",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076661845",
"telephone_number": "646-769-0469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 TILDEN AVE",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076661845",
"telephone_number": "646-769-0469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDOVINO",
"first_name": "RICHE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-25",
"last_updated": "2011-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01048100",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "62 023652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Teaneck, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.