Individual provider Active NPI

Gabriella Mitchell

  • Physical Therapist
  • Huntington, NY
National Provider Identifier
1235705773
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
755 New York Ave Ste 106
Huntington, NY 11743-4240
Phone
(631) 351-7676
Fax
(631) 351-7667
NPI assigned
Jun 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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 Primary

Addresses

Primary practice location

755 New York Ave Ste 106
Huntington, NY 11743-4240

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211008001827 NY Practitioner - Physical Therapist in Private Practice 9739587551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

755 New York Ave
Suite 106
Huntington, NY 11743-4240
Phone (631) 351-7676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Jul 7, 2021 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Jul 7, 2021 Accepting new patients

Locations

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

755 New York Ave
Ste 106
Huntington, NY 11743
Phone (631) 351-7616

576 Broadhollow Rd
Melville, NY 11747

5380 Nesconset Hwy
Port Jefferson Station, NY 11776
Phone (631) 474-4096

22005 Hillside Ave
Queens Village, NY 11427
Phone (718) 400-8330

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 3

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": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1235705773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 NEW YORK AVE STE 106",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434240",
            "telephone_number": "631-351-7676",
            "fax_number": "631-351-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "GABRIELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.