Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SAMUEL TIDALGO
NPI 1922831353
Physical Therapist in New York, NY

Active since August 21, 2024Accepts Medicare Assignment
139 FULTON ST RM 502, NEW YORK, NY 10038(315) 879-9481 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 29, 2026, Aug 21, 2024 (2 updates tracked since 2024).

About Samuel Tidalgo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL TIDALGO (NPI 1922831353) is an individual physical therapist in New York, New York, licensed in New York (046852) and active in the NPI registry since August 2024. He is a graduate of Other (1999).

NPPES Registry Identity

NPI1922831353
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameSAMUEL TIDALGO
Location Address139 FULTON ST RM 502New York, NY 10038-2535
Mailing Address139 Fulton St Rm 502New York, NY 10038-2535 · (315) 879-9481
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateAugust 21, 2024
Last NPPES UpdateSeptember 29, 20262 updates tracked since enumeration
NPPES CertifiedAugust 21, 2024
✔ NPI 1922831353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in NY · 046852
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
139 FULTON ST RM 502, New York, NY 10038

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel Tidalgo is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880126440
PECOS Enrollment IDI20250211003845

Medicare Billing Reassignments

2

Medicare enrollment records show Samuel Tidalgo reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Physical Therapist
266 HARRISTOWN RD STE 200
Glen Rock, NJ 07452
  • Reassigned Medicare billing, New Jersey enrollment
  • 224 clinicians in this Medicare group
Physical Therapist
3010 WESTCHESTER AVE, SUITE 107
Purchase, NY 10577
  • Reassigned Medicare billing, New York enrollment
  • 7 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110
This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.
86 services11 patients
Therapy procedure using manual technique, each 15 minutes 97140
This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.
47 services11 patients
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care G0283
Electrical stimulation is a therapy method where mild electrical pulses are used to treat pain or stimulate muscles in certain areas. It's not for wound care but is part of a broader therapy plan. It's safe, non-invasive, and can help improve overall health.
46 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10038 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Registered Nurse
139 FULTON ST RM 502
NEW YORK, NY 10038
Physical Therapist
139 FULTON ST RM 502
NEW YORK, NY 10038

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Tidalgo's NPI number?

The NPI number for Samuel Tidalgo is 1922831353. It was assigned to this individual provider in the NPPES registry on August 21, 2024.

Where is Samuel Tidalgo located?

Samuel Tidalgo practices at 139 Fulton St Rm 502, New York, NY 10038. The listed phone number is (315) 879-9481.

What is Samuel Tidalgo's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Samuel Tidalgo enrolled in Medicare?

Yes. Samuel Tidalgo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Samuel Tidalgo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Tidalgo reassigns Medicare benefits to 2 organizations: Sportsmed Pt LLC (Glen Rock, NJ) and Elite Physical Therapy And Rehabilitation LLC (Purchase, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Tidalgo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Tidalgo accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Samuel Tidalgo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Tidalgo was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.