Individual provider Active NPI

Tracy Jane L Bernardo, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1902243769
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
030794 Issued in NY
Practice address
1664 E 14TH St Ste 401
Brooklyn, NY 11229-1169
Phone
(718) 375-2300
Fax
(718) 513-6322
NPI assigned
Jun 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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 030794 NY Primary

Addresses

Primary practice location

1664 E 14TH St Ste 401
Brooklyn, NY 11229-1169

Mailing address

1664 E 14TH St Ste 401
Brooklyn, NY 11229-1169
Phone (718) 375-2300

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

LicenseStateTypeSpecialty
030794NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1902243769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 E 14TH ST STE 401",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291169",
            "telephone_number": "718-375-2300",
            "fax_number": "718-513-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 E 14TH ST STE 401",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291169",
            "telephone_number": "718-375-2300",
            "fax_number": "718-513-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDO",
        "first_name": "TRACY",
        "middle_name": "JANE L",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.