Active NPI
Benjamin Q Antonucci, P.T.
- Physical Therapist
- Rochester, NY
National Provider Identifier
1275919268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 038968
- Practice address
- 1100 Long Pond Rd
104
Rochester, NY 14626-1177 - Phone
- (585) 697-0207
- Fax
- (585) 697-0209
- NPI assigned
- Aug 3, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 038968 | NY | Primary |
Addresses
Primary practice location
1100 Long Pond Rd
104
Rochester, NY 14626-1177
Mailing address
1100 Long Pond Rd
104
Rochester, NY 14626-1177
Phone (585) 697-0207
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038968 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Encompass Health Rehabilitation Hospital of Florence, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rehabilitation Hospital
- Florence, SC
- NPI 1598738296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438560000000",
"number": "1275919268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 LONG POND RD",
"address_2": "104",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146261177",
"telephone_number": "585-697-0207",
"fax_number": "585-697-0209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 LONG POND RD",
"address_2": "104",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146261177",
"telephone_number": "585-697-0207",
"fax_number": "585-697-0209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTONUCCI",
"first_name": "BENJAMIN",
"middle_name": "Q",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-03",
"last_updated": "2015-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "038968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.