Elizabeth Marie Antonucci, DPT
Individual provider Active NPI Physical Therapist · East Patchogue, NY
NPI 1497300552 · NPPES record last updated Aug 6, 2019
Key facts
- NPI
- 1497300552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 191 Patchogue Yaphank Rd
East Patchogue, NY 11772-4899 - Phone
- (631) 775-0971
- Fax
- (631) 475-0975
- NPI assigned
- Aug 6, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Professional Care Physical Therapy and Rehabilitation P.C
Practice addresses (Care Compare)
191 Patchogue Yaphank Rd
East Patchogue, NY 11772-4899
Phone (631) 775-0971
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191126001349 | NY | Practitioner - Physical Therapist in Private Practice | 7517390974 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Care Physical Therapy and Rehabilitation P.C | Physical Therapist | Current |
Accepting new patients |
Locations
191 Patchogue Yaphank Rd
East Patchogue, NY 11772
Phone (631) 775-0971
159 Islip Ave
Islip, NY 11751
Phone (631) 650-6347
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NY | Yes |
Addresses
Primary practice location
191 Patchogue Yaphank Rd
East Patchogue, NY 11772-4899
Mailing address
191 Patchogue Yaphank Rd
East Patchogue, NY 11772-4899
Phone (631) 775-0971
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.professionalcarept.com |
Other providers in East Patchogue, NY
- Allied Rehab Medicine Services, P.C.
- Alternative Approach Acupuncture PLLC
- Elizabeth Altman-Giron
- Jennifer Lynn Andreopoulos
- Anthony N. Donatelli Jr MD., PC
- Denise Anzaldi
- Samuel Thomas Arcieri
- Sinthya Arguetta
- Melissa Frances Arrigo
- Attia Arshad-Noor
All providers in East Patchogue, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.