Active NPI
Nicole Iris Antiligando Gamban, DPT
- Physical Therapist
- New York, NY
National Provider Identifier
1962028761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 044765
- Practice address
- 369 Lexington Ave
26TH FL
New York, NY 10017 - Phone
- (212) 951-1483
- Fax
- (888) 646-5967
- NPI assigned
- Jun 18, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 044765-01 | NY | |
| Physical Therapist | 225100000X | 044765 | NY | Primary |
Addresses
Primary practice location
369 Lexington Ave
26TH FL
New York, NY 10017
Mailing address
369 Lexington Ave
26TH FL
New York, NY 10017
Phone (212) 951-1483
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 87.87 of 100
- Quality
- 88.31
- Improvement activities
- 40
- Cost
- 69.4
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044765 | NY | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 044765-01 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Heyligers DC PLLC | Single Specialty | Past | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696204800000",
"number": "1962028761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "369 LEXINGTON AVE",
"address_2": "26TH FL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10017",
"telephone_number": "212-951-1483",
"fax_number": "888-646-5967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "369 LEXINGTON AVE",
"address_2": "26TH FL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10017",
"telephone_number": "212-951-1483",
"fax_number": "888-646-5967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBAN",
"first_name": "NICOLE IRIS",
"middle_name": "ANTILIGANDO",
"name_prefix": "Ms.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-18",
"last_updated": "2023-10-02",
"certification_date": "2020-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "NY",
"license": "044765-01",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "044765",
"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 Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.