Individual provider Active NPI

Jessica Spagnoli

  • Physical Therapist
  • Centereach, NY
National Provider Identifier
1568709012
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
141 Mark Tree Rd
Centereach, NY 11720-2221
Phone
(631) 467-4235
Fax
(631) 467-2655
NPI assigned
Jan 3, 2013
Last updated
Jan 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 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 NU Primary

Addresses

Primary practice location

141 Mark Tree Rd
Centereach, NY 11720-2221

Mailing address

141 Mark Tree Rd
Centereach, NY 11720-2221
Phone (631) 467-4235

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140805001730 NY Practitioner - Physical Therapist in Private Practice 1254558851 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Spagnoli Physical Therapy PCGroup PAC ID 1254595200, 11 clinicians

Practice addresses (Care Compare)

141 Mark Tree Rd
Centereach, NY 11720-2221
Phone (631) 467-4235

Merit-based Incentive Payment System (MIPS)

Final score
60.81 of 100Reported as group
Quality
94.75
Improvement activities
0
Cost
76.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035865NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Spagnoli Physical Therapy, PC Physical Therapist CurrentSince May 1, 2014 Accepting new patients
Bienetre Medical PC Physical Therapist CurrentSince Nov 1, 2025 Accepting new patients

Locations

141 Mark Tree Rd
Centereach, NY 11720
Phone (631) 251-7577

99 Hudson St
Fl 5
New York, NY 10013
Phone (646) 301-2578

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1568709012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MARK TREE RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117202221",
            "telephone_number": "631-467-4235",
            "fax_number": "631-467-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MARK TREE RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117202221",
            "telephone_number": "631-467-4235",
            "fax_number": "631-467-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAGNOLI",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centereach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.