Individual provider Active NPI

Leonardo Danan Buluran, PT

  • Physical Therapist
  • Rockaway Park, NY
National Provider Identifier
1891504544
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
053767 Issued in NY
Practice address
231 Beach 116TH St
Rockaway Park, NY 11694-2102
Phone
(718) 474-2224
NPI assigned
Jan 6, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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 053767 NY Primary

Addresses

Primary practice location

231 Beach 116TH St
Rockaway Park, NY 11694-2102

Mailing address

5186 Manilla St
Elmhurst, NY 11373-4151
Phone (831) 521-2989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250109003407 NY Practitioner - Physical Therapist in Private Practice 0648708230 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

7215 Grand Ave
Maspeth, NY 11378-1575
Phone (718) 803-2058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
053767NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Apr 14, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Apr 14, 2025 Accepting new patients
One on One Physical Therapy Services PLLC Physical Therapist PastSince Jan 12, 2025 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

111 E 210th St
Bronx, NY 10467

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

1414 Newkirk Ave
Brooklyn, NY 11226
Phone (718) 434-4311

7215 Grand Ave
Maspeth, NY 11378
Phone (718) 803-2058

231 Beach 116th St
Rockaway Park, NY 11694
Phone (718) 474-2224

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 4

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": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1891504544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5186 MANILLA ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734151",
            "telephone_number": "831-521-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 BEACH 116TH ST",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942102",
            "telephone_number": "718-474-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULURAN",
        "first_name": "LEONARDO",
        "middle_name": "DANAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "053767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockaway Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.