Daniel Antonucci, DPT
Individual provider Active NPI Physical Therapist · Centreville, VA
NPI 1033064449 · NPPES record last updated Mar 2, 2026
Key facts
- NPI
- 1033064449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2305217622 (VA)
- Practice address
- 6325 Multiplex Dr Unit 2
Centreville, VA 20121-5327 - Phone
- (571) 932-3470
- Fax
- (571) 932-8075
- NPI assigned
- Mar 2, 2026
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Professional Sportscare and Rehab LLC
Practice addresses (Care Compare)
510 S Washington St
Suite a
Falls Church, VA 22046-4415
Phone (703) 992-7255
6325 Multiplex Dr
Unit 2
Centreville, VA 20121-5327
Phone (571) 932-3470
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA, DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260313000369 | VA | Practitioner - Physical Therapist in Private Practice | 9133602576 | Reassigns benefits to 2 organizations |
| I20260327004148 | DC | Practitioner - Physical Therapist in Private Practice | 9133602576 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305217622 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Sportscare & Rehab, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250
6325 Multiplex Dr
Unit 2
Centreville, VA 20121
Phone (571) 932-3470
510 S Washington St
#A
Falls Church, VA 22046
Phone (703) 992-7255
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305217622 | VA | Yes |
Addresses
Primary practice location
6325 Multiplex Dr Unit 2
Centreville, VA 20121-5327
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200
Other providers in Centreville, VA
- Phyllis Margo Anderson
- Aniqa Zaheer DDS PLLC
- Aniqa Zaheer DDS PLLC
- Anncolter H Cheron DMD Ms PLLC
- Adwoa Ansu-Anin
- Apollo Transportation, Inc.
- Jasmine Appleton
- Applied Neuropsychological Services PC
- Applied Neuropsychological Services, P.C.
- Scott H Apted
All providers in Centreville, VA · Physical Therapist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.