Ederly Heriberto Jimenez Dominguez, PTA
NPI 1487366860ActiveIndividual· Physical Therapy Assistant· Brooklyn, NY
Physical Therapy Assistant (PTA) in Brooklyn, New York, licensed in NY, with an NPI issued in December 2022.
Overview
| NPI | 1487366860 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PTA |
| Sole proprietor | Yes |
| NPI issued | Dec 19, 2022 |
| Last updated in NPPES | Dec 19, 2022 |
| Certified by provider | Dec 17, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | 010498 | 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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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