Individual provider Active NPI

Juan Guillermo Correa, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1881198091
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
042802-1 Issued in NY
Practice address
57 W 57TH St
New York, NY 10019-2802
Phone
(646) 790-7464
Fax
(212) 379-2075
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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 042802-1 NY Primary

Addresses

Primary practice location

57 W 57TH St
New York, NY 10019-2802

Mailing address

3704 Cliff Haven Dr
Raleigh, NC 27615-8118
Phone (302) 482-5589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180611002728 NY Practitioner - Physical Therapist in Private Practice 8820343007 Reassigns benefits to 1 organization
I20250220000534 NC Practitioner - Physical Therapist in Private Practice 8820343007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042802NYMDDentist
042802-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Dec 16, 2024 Accepting new patients
Duke University Health System, Inc. Physical Therapist CurrentSince Dec 16, 2024 Accepting new patients
Spear Physical and Occupational Therapy, LLC Physical Therapist CurrentSince May 29, 2018 Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3000 Erwin Rd
Durham, NC 27705
Phone (919) 668-3988

57 W 57th St
Fl 15
New York, NY 10019
Phone (212) 289-0700

120 E 56th St
Rm 1010
New York, NY 10022
Phone (646) 790-7466

307 5th Ave
Fl 6
New York, NY 10016
Phone (646) 790-7464

31 E 32nd St
Fl 4
New York, NY 10016
Phone (646) 973-5427

Organizations & group practices 3

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1881198091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 CLIFF HAVEN DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276158118",
            "telephone_number": "302-482-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W 57TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192802",
            "telephone_number": "646-790-7464",
            "fax_number": "212-379-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "JUAN",
        "middle_name": "GUILLERMO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042802-1",
            "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 Nov 26, 2024; 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.