Active NPI
Phelandrecis Balmonte Rayco, R.P.T.
- Physical Therapist
- New York, NY
National Provider Identifier
1942473681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 028942-1
- Practice address
- 460 Grand Street
New York, NY 10002 - Phone
- (121) 256-6885
- NPI assigned
- Apr 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 028942-1 | NY | Primary |
Addresses
Primary practice location
460 Grand Street
New York, NY 10002
Mailing address
1839 Holland Ave
2ND FLR
Bronx, NY 10462
Phone (732) 850-8660
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
| License | State | Type | Specialty |
|---|---|---|---|
| 028942-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Home-Based Physical Therapy PLLC | Physical Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Woodmere, NY
- NPI 1356900989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207094400000",
"number": "1942473681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1839 HOLLAND AVE",
"address_2": "2ND FLR",
"city": "BRONX",
"state": "NY",
"postal_code": "10462",
"telephone_number": "732-850-8660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "460 GRAND STREET",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10002",
"telephone_number": "121-256-6885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYCO",
"first_name": "PHELANDRECIS",
"middle_name": "BALMONTE",
"credential": "R.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-02",
"last_updated": "2008-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "028942-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.