Individual provider Active NPI

Ana Samantha Antonio, PT

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1023724770
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045303 Issued in NY
Practice address
4343 Kissena Blvd Ste 110
Flushing, NY 11355-2914
Phone
(718) 661-1770
Fax
(718) 886-6414
NPI assigned
Jan 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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 045303 NY Primary

Addresses

Primary practice location

4343 Kissena Blvd Ste 110
Flushing, NY 11355-2914

Mailing address

57 Crescent Dr
Albertson, NY 11507-1101
Phone (718) 661-1710

Other practice location 1

3308 35th Ave
Astoria, NY 11106-1221
Phone (718) 799-6309

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230302001844 NY Practitioner - Physical Therapist in Private Practice 2365815800 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
88.31
Improvement activities
40
Cost
69.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045303NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Physical Therapy Services PC Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
New York Luna Care Physical Therapy PLLC Physical Therapist CurrentSince Apr 6, 2023 Accepting new patients
Shasta Health Physical Therapy Ny PC Physical Therapist CurrentSince May 2, 2025 Accepting new patients
Soni Care Physical Therapy PC Physical Therapist PastSince Jan 29, 2023 Accepting new patients

Locations

4343 Kissena Blvd
Ste 110
Flushing, NY 11355
Phone (718) 463-1515

924 N Broadway
Massapequa, NY 11758
Phone (516) 520-5507

169 Madison Ave
Ste 11071
New York, NY 10016
Phone (833) 270-9820

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

Organizations & group practices 4

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": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1023724770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 CRESCENT DR",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115071101",
            "telephone_number": "718-661-1710",
            "fax_number": "718-886-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 KISSENA BLVD STE 110",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552914",
            "telephone_number": "718-661-1770",
            "fax_number": "718-886-6414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3308 35th Ave",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111061221",
            "country_code": "US",
            "telephone_number": "718-799-6309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTONIO",
        "first_name": "ANA",
        "middle_name": "SAMANTHA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.