Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samuel Tidalgo

Individual provider Physical Therapist · NPI 1922831353

Samuel Tidalgo is registered under Physical Therapist in Private Practice in New York, New York. Qualified in 1999, 27 years ago. Practices with Sportsmed PT LLC, a 214-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
27
Licensed in
NY
In the registry since
2024
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Practice location Address checks out

139 Fulton St Rm 502
New York, NY 10038-2535
Phone: (315) 879-9481
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 046852 (NY)

Record details

NPI number1922831353
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 21, 2024
Last updated in NPPESAugust 21, 2024
Certification dateAugust 21, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Sportsmed Pt Llc — 214 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients11
Services billed 233 a service is one billed item, such as a visit, a test or a procedure
Average patient age74

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Sportsmed PT LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 214 clinicians in the practice; 12 are shown here.

Other providers in New York