Anthony Fuentes, DPT

Individual provider Active NPI Physical Therapist · East Quogue, NY

NPI 1326544693 · NPPES record last updated Jun 21, 2023

Key facts

NPI
1326544693
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
4 Eisenhower Dr
East Quogue, NY 11942-4730
Phone
(617) 319-6367
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seth Greiner PT PLLC (6 clinicians)

Practice addresses (Care Compare)

170 Montauk Hwy
Speonk, NY 11972
Phone (631) 596-5096

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230929000179 NY Practitioner - Physical Therapist in Private Practice 3173977873 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
050718NYMDPharmacist
P09803NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seth Greiner PT PLLC Physical Therapist Current
since Aug 26, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P09803 NY
Physical Therapist 225100000X NY Yes

Addresses

Primary practice location

4 Eisenhower Dr
East Quogue, NY 11942-4730

Mailing address

107 Auborn Ave
Shirley, NY 11967-1739
Phone (631) 741-8947

Other practice location 1

240 Meeting House Ln
Southampton, NY 11968-5009
Phone (631) 726-8200

Other providers in East Quogue, NY

All providers in East Quogue, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.