NPIMap

Individual provider Active NPI

Tracie Delsesto, PT, MBA

  • Physical Therapist
  • Cranston, RI
National Provider Identifier
1881983138
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00883 Issued in RI
Practice address
940 Reservoir Ave
Suite a
Cranston, RI 02910-4418
Phone
(401) 228-3939
Fax
(401) 383-3043
NPI assigned
Apr 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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 PT00883 RI Primary

Addresses

Primary practice location

940 Reservoir Ave
Suite a
Cranston, RI 02910-4418

Mailing address

940 Reservoir Ave
Suite a
Cranston, RI 02910-4418
Phone (401) 228-3939

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
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
PT00883RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald J. Tyszkowski, DC Past Accepting new patients
Gaffney Physical Therapy, LLC Physical Therapist Past Accepting new patients

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": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1881983138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 RESERVOIR AVE",
            "address_2": "SUITE A",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104418",
            "telephone_number": "401-228-3939",
            "fax_number": "401-383-3043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 RESERVOIR AVE",
            "address_2": "SUITE A",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104418",
            "telephone_number": "401-228-3939",
            "fax_number": "401-383-3043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELSESTO",
        "first_name": "TRACIE",
        "name_prefix": "Ms.",
        "credential": "PT, MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT00883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.