Active NPI
Destiny Hance
- Physical Therapist
- Wantagh, NY
National Provider Identifier
1417559337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1169 Wantagh Ave
Wantagh, NY 11793-2136 - Phone
- (516) 785-4800
- NPI assigned
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NY | Primary |
Addresses
Primary practice location
1169 Wantagh Ave
Wantagh, NY 11793-2136
Mailing address
1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050
Other practice location 1
74 Commerce Ave Ste 3
Riverhead, NY 11901-3105
Phone (631) 369-9110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700
15 Foster Ave
Sayville, NY 11782-3109
Phone (631) 815-1923
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Occupational Therapist
- Garden City, NY
- NPI 1356742365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646092800000",
"number": "1417559337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 MAMARONECK AVE STE 140",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106055224",
"telephone_number": "914-294-4050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1169 WANTAGH AVE",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117932136",
"telephone_number": "516-785-4800"
}
],
"practiceLocations": [
{
"address_1": "74 Commerce Ave Ste 3",
"address_purpose": "LOCATION",
"city": "Riverhead",
"state": "NY",
"postal_code": "119013105",
"country_code": "US",
"telephone_number": "631-369-9110",
"fax_number": "631-369-9004",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HANCE",
"first_name": "DESTINY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-16",
"last_updated": "2022-03-01",
"certification_date": "2022-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wantagh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.