Individual provider Active NPI

Destiny Hance

  • Physical Therapist
  • Wantagh, NY
National Provider Identifier
1417559337
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
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

Updated by the provider on Mar 1, 2022

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 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

Enrollment IDStateProvider typePAC IDDetails
I20201202001328 NY Practitioner - Physical Therapist in Private Practice 9931510641 Reassigns benefits to 3 organizations

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
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

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.

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.

Verify at the official NPI Registry.