Individual provider Active NPI

Abigail Marie Agustero Docena

  • Physical Therapist
  • Forest Hills, NY
National Provider Identifier
1003044736
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026083 Issued in NY
Practice address
11045 Queens Blvd
Suite 105
Forest Hills, NY 11375-5501
Phone
(718) 575-5100
NPI assigned
Jul 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 026083 NY Primary

Addresses

Primary practice location

11045 Queens Blvd
Suite 105
Forest Hills, NY 11375-5501

Mailing address

12 Cedar Rd
Westbury, NY 11590-2729
Phone (917) 470-4497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121218000062 NY Practitioner - Physical Therapist in Private Practice 7810149937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9525 Queens Blvd
Suite 3D
Rego Park, NY 11374-4510
Phone (718) 925-6212

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026083NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Aug 14, 2023 Accepting new patients

Locations

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1003044736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CEDAR RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115902729",
            "telephone_number": "917-470-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11045 QUEENS BLVD",
            "address_2": "SUITE 105",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755501",
            "telephone_number": "718-575-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCENA",
        "first_name": "ABIGAIL MARIE",
        "middle_name": "AGUSTERO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.