Michelle Lee Agin
Individual provider Active NPI Physical Therapist · Great Neck, NY
NPI 1316255482 · NPPES record last updated Feb 25, 2016
Key facts
- NPI
- 1316255482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 020904 (NY)
- Practice address
- 475 Northern Blvd
Suite 11
Great Neck, NY 11021-4819 - Phone
- (516) 829-0030
- Fax
- (516) 466-7723
- NPI assigned
- Sep 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fox Rehabilitation Physical Therapy Services LLC
Practice addresses (Care Compare)
1844 2ND Ave
New York, NY 10128-3862
Phone (877) 407-3422
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160302002317 | NY | Practitioner - Physical Therapist in Private Practice | 2062718992 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Physical Therapy Services LLC | Physical Therapist | Current |
Accepting new patients |
| Reddy Care Physical Therapy PC | Physical Therapist | Current |
Accepting new patients |
Locations
309 Northwest Dr
Farmingdale, NY 11735
Phone (516) 420-2900
475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023
1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 020904 | NY | Yes |
Addresses
Primary practice location
475 Northern Blvd
Suite 11
Great Neck, NY 11021-4819
Mailing address
475 Northern Blvd
Suite 11
Great Neck, NY 11021-4819
Phone (516) 829-0030
Other providers in Great Neck, NY
- Ageless Mind Ny Inc
- Elham Aghajani
- Natalie Aghajani
- Ariella Aghalarian
- Alysson Aghelian
- Vishaal Agrawal
- Ana Rheeda Del Mundo Aguilar
- Cera Reodica Aguiling
- Yigal Aharon
- Melody Ahdoot
All providers in Great Neck, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2016. 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.