Irsam Yape Doligon, PHYSICAL THERAPIST
NPI 1417326067ActiveIndividual· Physical Therapy Assistant· Bronx, NY
Physical Therapy Assistant (PHYSICAL THERAPIST) with Evergreen Physical Therapy PC, practicing in Bronx, New York. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1417326067 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHYSICAL THERAPIST |
| Sole proprietor | No |
| NPI issued | Sep 24, 2015 |
| Last updated in NPPES | Oct 26, 2021 |
| Certified by provider | Oct 26, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | 009363 | NY |
| Physical Therapist | 225100000X | 047656 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (NY) |
|---|
Education and affiliations
| Graduation year | 1999 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Evergreen Physical Therapy PCNew York, NY · 2 clinicians
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All 79 physical therapist assistants in Bronx · All physical therapist assistants in New York