Individual provider Active NPI

Jennifer Marie Labita, PT, DPT

  • Physical Therapist
  • Huntington, NY
National Provider Identifier
1366101008
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
048330 Issued in NY
Practice address
175 E Main St Ste 110
Huntington, NY 11743-2981
Phone
(631) 427-7600
Fax
(631) 427-7636
NPI assigned
Dec 9, 2021
Last updated
Dec 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 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 048330 NY Primary

Addresses

Primary practice location

175 E Main St Ste 110
Huntington, NY 11743-2981

Mailing address

332 N Albany Ave
N Massapequa, NY 11758-2114
Phone (516) 946-4247

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221107003380 MA Practitioner - Physical Therapist in Private Practice 2466844857 Reassigns benefits to 2 organizations

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
Boston Health and Wellness LLCGroup PAC ID 2961823760, 9 clinicians

Practice addresses (Care Compare)

62 Montvale Ave
Suite Z
Stoneham, MA 02180-3600
Phone (617) 843-5320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048330NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Health & Wellness, LLC Physical Therapist CurrentSince Jan 31, 2024 Accepting new patients
Rom on the Run Physical Therapy, PC Physical Therapist PastSince Dec 12, 2021 Accepting new patients

Locations

62 Montvale Ave
Ste Z
Stoneham, MA 02180
Phone (617) 843-5320

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1366101008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 N ALBANY AVE",
            "city": "N MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582114",
            "telephone_number": "516-946-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E MAIN ST STE 110",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432981",
            "telephone_number": "631-427-7600",
            "fax_number": "631-427-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABITA",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048330",
            "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 Dec 9, 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.