Individual provider Active NPI

Antonia Marie Meditz, PTA

  • Physical Therapy Assistant
  • Glen Cove, NY
National Provider Identifier
1376355313
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
014619 Issued in NY
Practice address
214 Glen Cove Ave
Glen Cove, NY 11542-4101
Phone
(516) 268-3555
NPI assigned
Jan 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 014619 NY Primary

Addresses

Primary practice location

214 Glen Cove Ave
Glen Cove, NY 11542-4101

Mailing address

214 Glen Cove Ave
Glen Cove, NY 11542-4101
Phone (516) 268-3555

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
014619NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path CurrentSince Feb 2, 2025 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC PastSince Feb 2, 2025 Accepting new patients

Locations

214 Glen Cove Ave
Glen Cove, NY 11542
Phone (516) 268-3555

Organizations & group practices 2

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": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1376355313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 GLEN COVE AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115424101",
            "telephone_number": "516-268-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 GLEN COVE AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115424101",
            "telephone_number": "516-268-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDITZ",
        "first_name": "ANTONIA",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "014619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.