Active NPI
Evelyn Bermudez Montero, P.T.
- Physical Therapist
- Rosedale, NY
National Provider Identifier
1871789685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 020016
- Practice address
- 23520 147TH Ave
Suite5
Rosedale, NY 11422-3293 - Phone
- (718) 341-5313
- Fax
- (717) 528-3534
- NPI assigned
- Sep 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 020016 | NY | Primary |
Addresses
Primary practice location
23520 147TH Ave
Suite5
Rosedale, NY 11422-3293
Mailing address
23520 147TH Ave
Suite5
Rosedale, NY 11422-3293
Phone (718) 341-5313
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020016 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gastrointestinal Care of Long Island PLLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Gastroenterology Physician
- Massapequa, NY
- NPI 1265571863
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1871789685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23520 147TH AVE",
"address_2": "SUITE5",
"city": "ROSEDALE",
"state": "NY",
"postal_code": "114223293",
"telephone_number": "718-341-5313",
"fax_number": "717-528-3534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23520 147TH AVE",
"address_2": "SUITE5",
"city": "ROSEDALE",
"state": "NY",
"postal_code": "114223293",
"telephone_number": "718-341-5313",
"fax_number": "717-528-3534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTERO",
"first_name": "EVELYN",
"middle_name": "BERMUDEZ",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-15",
"last_updated": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "020016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosedale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.