Individual provider Active NPI

Aileen Joy Maravilla Lagunilla, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1861441669
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
012688-1 Issued in NY
Practice address
122 E 23Rd St
New York, NY 10010-4516
Phone
(212) 677-7400
Fax
(212) 529-2071
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 012688-1 NY Primary

Addresses

Primary practice location

122 E 23Rd St
New York, NY 10010-4516

Mailing address

2113 Salisbury Park Dr
Westbury, NY 11590-6313
Phone (516) 312-6474

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120308000149 NY Practitioner - Physical Therapist in Private Practice 0648439885 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012688-1NYMDPhysical Therapist
012688NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy of New York City Inc CurrentSince Apr 29, 2011 Accepting new patients

Locations

175 Lawrence Ave
Brooklyn, NY 11230
Phone (718) 436-7600

80 Maiden Ln
Fl 12
New York, NY 10038

122 E 23rd St
New York, NY 10010
Phone (718) 993-3458

80 Maiden Ln
Fl 8
New York, NY 10038
Phone (347) 971-2368

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861441669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2113 SALISBURY PARK DR",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115906313",
            "telephone_number": "516-312-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E 23RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104516",
            "telephone_number": "212-677-7400",
            "fax_number": "212-529-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGUNILLA",
        "first_name": "AILEEN JOY",
        "middle_name": "MARAVILLA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012688-1",
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.