Individual provider Active NPI

Mary Jane Fernandez Vilchez, PT

  • Physical Therapist
  • Briarwood, NY
National Provider Identifier
1942441837
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
030162 Issued in NY
Practice address
14436 87TH Rd
Briarwood, NY 11435-3124
Phone
(929) 478-0660
NPI assigned
Mar 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 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 030162 NY Primary

Addresses

Primary practice location

14436 87TH Rd
Briarwood, NY 11435-3124

Mailing address

9059 55TH Ave Apt 2
Elmhurst, NY 11373-4560
Phone (347) 681-5812

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090925000114 NY Practitioner - Physical Therapist in Private Practice 6103972617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030162NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Physical Therapy PC Physical Therapist PastSince Jan 1, 2023 Accepting new patients
Yakov Raufov Medical PC PastSince Dec 28, 2009 Accepting new patients
Atlantic Anesthesia /Pain Management Medical Services P.C. Past Accepting new patients
Blue Sky Physical Therapy Services PC Physical Therapist PastSince Jun 1, 2024 Accepting new patients

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • 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": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1942441837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9059 55TH AVE APT 2",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734560",
            "telephone_number": "347-681-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14436 87TH RD",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114353124",
            "telephone_number": "929-478-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILCHEZ",
        "first_name": "MARY JANE",
        "middle_name": "FERNANDEZ",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Briarwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.