Individual provider Active NPI

Alicia Venezia, PT

  • Physical Therapist
  • Forest Hills, NY
National Provider Identifier
1598988404
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
015794-1 Issued in NY
Practice address
6715 102ND St Apt 2H
Forest Hills, NY 11375-2407
Phone
(646) 756-0646
Fax
(718) 896-0974
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 015794-1 NY Primary

Addresses

Primary practice location

6715 102ND St Apt 2H
Forest Hills, NY 11375-2407

Mailing address

6715 102ND St Apt 2H
Forest Hills, NY 11375-2407
Phone (646) 756-0646

Other identifiers 1

IdentifierTypeStateIssuer
015794-1OtherNYLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070607000083 NY Practitioner - Physical Therapist in Private Practice 4688772197 Reassigns benefits to 1 organization
Practice locations: Forest Hills, NY

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9525 Queens Blvd
Suite 3D
Rego Park, NY 11374-4510
Phone (718) 925-6212

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015794NYMDMental Health Counselor
015794-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Apr 1, 2021 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Apr 1, 2021 Accepting new patients

Locations

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598988404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 102ND ST APT 2H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752407",
            "telephone_number": "646-756-0646",
            "fax_number": "718-896-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6715 102ND ST APT 2H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752407",
            "telephone_number": "646-756-0646",
            "fax_number": "718-896-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEZIA",
        "first_name": "ALICIA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015794-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "015794-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.