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

Shannen Ivy Rillera Bascao

Individual provider Physical Therapy Assistant · NPI 1841953858

Shannen Ivy Rillera Bascao is a Physical Therapist in Private Practice in Jackson Heights, New York. Qualified in 2018, 8 years ago. Practices with Alexander Dolsky Ptpc, a 5-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

9033 Elmhurst Ave
Jackson Heights, NY 11372-7935
Phone: (718) 565-2970
Fax: (718) 565-2972
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11045 Queens Blvd Ste 105, Forest Hills, NY 11375-5519 — (718) 575-5100

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 049327 (NY)
Physical Therapy Assistant Taxonomy 225200000X · Licence 012416 (NY)

Record details

NPI number1841953858
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 16, 2021
Last updated in NPPESNovember 18, 2022
Certification dateNovember 18, 2022

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Alexander Dolsky Ptpc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Jackson Heights