Individual provider Active NPI

Emmanuel Antonio Garcia

  • Physical Therapist
  • Astoria, NY
National Provider Identifier
1841015948
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
053357 Issued in NY
Practice address
2103 31St Ave
Astoria, NY 11106-4521
Phone
(646) 875-8348
NPI assigned
Nov 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 053357 NY Primary

Addresses

Primary practice location

2103 31St Ave
Astoria, NY 11106-4521

Mailing address

4706 49TH St Apt 2C
Woodside, NY 11377-6723
Phone (917) 589-3755

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250318000612 NY Practitioner - Physical Therapist in Private Practice 8426570649 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kellen Ryan Scantlebury Physical Therapy PLLCGroup PAC ID 8325578339, 5 clinicians

Practice addresses (Care Compare)

2103 31St Ave
Astoria, NY 11106-4521
Phone (646) 875-8348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
053357NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kellen Ryan Scantlebury Physical Therapy PLLC Physical Therapist CurrentSince Mar 11, 2025 Accepting new patients
Fit Club Inc Physical Therapist CurrentSince Feb 23, 2025 Accepting new patients

Locations

203 Berry St
Brooklyn, NY 11249
Phone (646) 875-8348

153 W 27th St
Ste 1204
New York, NY 10001
Phone (646) 875-8348

153 W 27th St
Ste 1201
New York, NY 10001

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1841015948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4706 49TH ST APT 2C",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113776723",
            "telephone_number": "917-589-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 31ST AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111064521",
            "telephone_number": "646-875-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "EMMANUEL",
        "middle_name": "ANTONIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "053357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.