Individual provider Active NPI

Irene Pauline Padilla Ilagan, DPT

  • Physical Therapist
  • Woodside, NY
National Provider Identifier
1417569377
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
038695 Issued in NY
Practice address
4413 65TH St
Woodside, NY 11377-5758
Phone
(929) 253-2418
NPI assigned
Aug 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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 038695 NY Primary

Addresses

Primary practice location

4413 65TH St
Woodside, NY 11377-5758

Mailing address

4413 65TH St
Woodside, NY 11377-5758
Phone (929) 253-2418

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200908002112 NY Practitioner - Physical Therapist in Private Practice 4880012806 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

4701 Queens Blvd
Sunnyside, NY 11104-1660
Phone (917) 310-2772

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
72.13
Promoting interoperability
91
Improvement activities
40
Cost
75.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038695NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Luna Care Physical Therapy PLLC Physical Therapist CurrentSince Feb 24, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Feb 24, 2022 Accepting new patients
Link Home Therapy Services of Ny-PT OT SLP PLLC CurrentSince Aug 1, 2020 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jul 16, 2023 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Optum Medical Care, P.C. CurrentSince Jul 16, 2023 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Feb 24, 2022 Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

121 Broadhollow Rd
Melville, NY 11747
Phone (631) 354-5600

576 Broadhollow Rd
Melville, NY 11747

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

4701 Queens Blvd
Sunnyside, NY 11104
Phone (718) 482-8900

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 7

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": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1417569377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 65TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113775758",
            "telephone_number": "929-253-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 65TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113775758",
            "telephone_number": "929-253-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILAGAN",
        "first_name": "IRENE PAULINE",
        "middle_name": "PADILLA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "038695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.