Individual provider Active NPI

Courtney Marie Prezioso, MPT

  • Physical Therapist
  • Manhasset, NY
National Provider Identifier
1386984516
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032555-1 Issued in NY
Practice address
585 Plandome Rd
Manhasset, NY 11030-1968
Phone
(516) 869-5576
NPI assigned
Feb 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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 032555-1 NY Primary

Addresses

Primary practice location

585 Plandome Rd
Manhasset, NY 11030-1968

Mailing address

6525 160TH St
Apt 11B
Flushing, NY 11365-2567
Phone (917) 346-6962

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130419000467 NY Practitioner - Physical Therapist in Private Practice 8224274139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pro Sports Performance Physical Therapy PCGroup PAC ID 8123163599, 3 clinicians

Practice addresses (Care Compare)

1399 Franklin Ave
Suite 102
Garden City, NY 11530-1625
Phone (516) 427-5577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
032555-1NYMDPhysical Therapist
032555NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Sports Performance Physical Therapy PC CurrentSince Sep 9, 2015 Accepting new patients
Shelter Rock Orthopedic Group, PC Past Accepting new patients

Locations

1399 Franklin Ave
Ste 102
Garden City, NY 11530
Phone (516) 427-5577

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": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1386984516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 160TH ST",
            "address_2": "APT 11B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113652567",
            "telephone_number": "917-346-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 PLANDOME RD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110301968",
            "telephone_number": "516-869-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREZIOSO",
        "first_name": "COURTNEY MARIE",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-25",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032555-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.