Individual provider Active NPI

Jennifer Soleil Maldonado Emanuelli, PTA

  • Physical Therapy Assistant
  • Cidra, PR
National Provider Identifier
1861736894
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2035 Issued in PR
Practice address
4 Calle Kennedy
Urb Fernandez
Cidra, PR 00739-3455
Phone
(787) 714-0510
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2035 PR Primary

Addresses

Primary practice location

4 Calle Kennedy
Urb Fernandez
Cidra, PR 00739-3455

Mailing address

4 Calle Kennedy
Urb Fernandez
Cidra, PR 00739-3455
Phone (787) 714-0510

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

LicenseStateTypeSpecialty
2035PRMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1861736894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CALLE KENNEDY",
            "address_2": "URB FERNANDEZ",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007393455",
            "telephone_number": "787-714-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CALLE KENNEDY",
            "address_2": "URB FERNANDEZ",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007393455",
            "telephone_number": "787-714-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO EMANUELLI",
        "first_name": "JENNIFER",
        "middle_name": "SOLEIL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PR",
            "license": "2035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cidra, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.