Peter John Arebalo IV, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

012980-01 Issued in NY

Practice address

639 Commack Rd
Commack, NY 11725-5417

Phone

(631) 834-0246

NPI assigned

May 22, 2020

Last updated

May 22, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Enso Acupuncture and Massage, PLLC

  • Family Medicine Physician
  • Melville, NY
  • NPI 1528951084

  Multi-Specialty

  NPD Authorized official

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1851914030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GAMECOCK LN",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023102",
            "telephone_number": "631-834-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255417",
            "telephone_number": "631-834-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AREBALO",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_suffix": "IV",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "012980-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Antonow
• Nicholas Frederick Aquino, AU.D
• Jamie Elissa Aranoff, CCC-SLP
• Jenna Aranoff, M.A.
• Elizabeth Archey, LCSW
• Lisa Armentano, SP. ED. MS
• Shari Michele Aronow-Roth, PA
• Marisa Arra
• Arthur Feigenbaum DMD PLLC
• Artistic Dental Associates of Commack LLP

• Massage Therapist in Commack, NY
• Providers in Commack, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.