Individual provider Active NPI

Agnieszka Antecka, PT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1326258179
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
020790 Issued in NY
Practice address
4434 Amboy Rd
Empire Physical Therapy
Staten Island, NY 10312
Phone
(718) 227-7015
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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 020790 NY Primary

Addresses

Primary practice location

4434 Amboy Rd
Empire Physical Therapy
Staten Island, NY 10312

Mailing address

613 Newman PL Apt 6
Roselle, NJ 07203-2859
Phone (908) 620-3990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080623000120 NY Practitioner - Physical Therapist in Private Practice 7214008077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agnieszka Antecka PT PCGroup PAC ID 5193988335, 2 clinicians

Practice addresses (Care Compare)

4434 Amboy Rd
Suite 2
Staten Island, NY 10312-3866
Phone (718) 227-7015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Agnieszka Antecka PT PC Physical Therapist CurrentSince Apr 20, 2012 Accepting new patients
Regina Management Co. Inc. Past Accepting new patients
Gerard Fiordalisi PT PC Physical Therapist Past Accepting new patients

Locations

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

4434 Amboy Rd
Ste 2
Staten Island, NY 10312
Phone (718) 227-7015

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1326258179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 NEWMAN PL APT 6",
            "city": "ROSELLE",
            "state": "NJ",
            "postal_code": "072032859",
            "telephone_number": "908-620-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4434 AMBOY RD",
            "address_2": "EMPIRE PHYSICAL THERAPY",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10312",
            "telephone_number": "718-227-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTECKA",
        "first_name": "AGNIESZKA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.