Individual provider Active NPI

Pasquale Iannucci, DPT

  • Physical Therapist
  • East Northport, NY
National Provider Identifier
1215378617
Registry record updated Jul 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62035289 Issued in NY
Practice address
279 Larkfield Rd
East Northport, NY 11731-2415
Phone
(631) 262-1370
NPI assigned
Jul 13, 2013
Last updated
Jul 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2013

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 62035289 NY Primary

Addresses

Primary practice location

279 Larkfield Rd
East Northport, NY 11731-2415

Mailing address

1985 Cedar Swamp Rd Unit 5
Glen Head, NY 11545-3154

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160216002032 NY Practitioner - Physical Therapist in Private Practice 3072818806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, shared by 41 NPIs, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

800 E Gate Blvd
Garden City, NY 11530-2105
Phone (516) 745-8070

Merit-based Incentive Payment System (MIPS)

Final score
77.35 of 100Reported as group
Quality
73.31
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62035289NYMDPhysical Therapist
035289NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince May 8, 2024 Accepting new patients
Suffolk County Physical Therapy P C Physical Therapist CurrentSince Oct 7, 2019 Accepting new patients

Locations

279 Larkfield Rd
East Northport, NY 11731
Phone (631) 261-1370

163 New Hyde Park Rd
Franklin Square, NY 11010
Phone (516) 616-1111

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1373673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373673600000",
    "number": "1215378617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 CEDAR SWAMP RD UNIT 5",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115453154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312415",
            "telephone_number": "631-262-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNUCCI",
        "first_name": "PASQUALE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-13",
        "last_updated": "2013-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "62035289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2013; 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.