Individual provider Active NPI

Maya Corretta Letourneau, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1851010813
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02116300 Issued in NJ
Practice address
333 E 56TH St
New York, NY 10022-3758
Phone
(212) 317-1600
NPI assigned
Aug 24, 2022
Last updated
Aug 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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 40QA02116300 NJ Primary

Addresses

Primary practice location

333 E 56TH St
New York, NY 10022-3758

Mailing address

225 Grand St Apt 2a
Hoboken, NJ 07030-2503
Phone (323) 899-5613

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221209000678 NY Practitioner - Physical Therapist in Private Practice 4688043847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutton Place Physical Therapy PCGroup PAC ID 8921999046, 13 clinicians

Practice addresses (Care Compare)

333 E 56TH St
New York, NY 10022-3758
Phone (212) 317-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02116300NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutton Place Physical Therapy PC Physical Therapist CurrentSince Oct 18, 2022 Accepting new patients

Locations

333 E 56th St
New York, NY 10022
Phone (212) 317-1600

333 E 56th St
Ofc 1
New York, NY 10022
Phone (212) 289-3236

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1851010813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 GRAND ST APT 2A",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070302503",
            "telephone_number": "323-899-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E 56TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223758",
            "telephone_number": "212-317-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETOURNEAU",
        "first_name": "MAYA",
        "middle_name": "CORRETTA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02116300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.