Individual provider Active NPI

Angela Ritieni, PT, DPT

  • Specialist
  • Miller Place, NY
National Provider Identifier
1598015158
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
017935-1 Issued in NY
Practice address
41 Echo Ave
Miller Place, NY 11764-2108
Phone
(631) 331-2348
Fax
(631) 928-7068
NPI assigned
Sep 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 017935-1 NY Primary

Addresses

Primary practice location

41 Echo Ave
Miller Place, NY 11764-2108

Mailing address

460 Old Town Rd
BLG 3, Apt. E
Port Jefferson Station, NY 11776-2200
Phone (516) 770-8656

Other practice location 1

460 Old Town Road
Apt 3E
Port Jefferson Station, NY 11776
Phone (516) 770-8656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121115000009 NY Practitioner - Physical Therapist in Private Practice 6507017829 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017935-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Theradynamics Rehab. PT, OT & SLP, PLLC CurrentSince Sep 12, 2025 Accepting new patients
One on One Physical Therapy Services PLLC PastSince Mar 20, 2023 Accepting new patients

Locations

161 E Gun Hill Rd
Bronx, NY 10467
Phone (718) 547-2011

280 W 231st St
Bronx, NY 10463
Phone (718) 548-1212

18716 Hillside Ave
Jamaica, NY 11432
Phone (718) 206-1288

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": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1598015158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 OLD TOWN RD",
            "address_2": "BLG 3, APT. E",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762200",
            "telephone_number": "516-770-8656",
            "fax_number": "516-770-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 ECHO AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642108",
            "telephone_number": "631-331-2348",
            "fax_number": "631-928-7068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Old Town Road",
            "address_2": "Apt 3E",
            "address_purpose": "LOCATION",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "country_code": "US",
            "telephone_number": "516-770-8656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RITIENI",
        "first_name": "ANGELA",
        "name_prefix": "Miss",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "017935-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miller Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.