Jarra Mae Santos Gonzales, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

013280 Issued in NY

Practice address

1760 Dutch Broadway
Elmont, NY 11003-5006

Phone

(516) 812-6145

NPI assigned

Aug 31, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Summit Physical Therapy and Rehabilitation, PLLC

  • Physical Therapist
  • Elmont, NY
  • NPI 1700327087
  NPD (past)

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1922728781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 DUTCH BROADWAY",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110035006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 DUTCH BROADWAY",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110035006",
            "telephone_number": "516-812-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JARRA MAE",
        "middle_name": "SANTOS",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "013280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "WEBPT",
            "affiliation": "N",
            "endpointDescription": "WebPT EMR Software",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "WEBPT Scheduling Software",
            "address_1": "1760 Dutch Broadway",
            "city": "Elmont",
            "state": "NY",
            "country_code": "US",
            "postal_code": "110035006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Global Health Center Corp.
• Cheryl B Goldstein, LCSW
• Samuel Benjamin Golub, M.D.
• Neha Hemalkumar Golwala
• Monica Patricia Gomez
• Alexa Gonzalez
• Good Care Physical Therapy, P.C.
• Shimi Gopalakrishnan, PHARMD.
• Martine Gouin
• Christha Gourdet

• Physical Therapy Assistant in Elmont, NY
• Providers in Elmont, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.