Individual provider Active NPI

Kia Nichole Antipuesto, PT, DPT

  • Physical Therapist
  • Queens, NY
National Provider Identifier
1639844434
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045667 Issued in NY
Practice address
140-40 Sanford Avenue
Queens, NY 11355-2556
Phone
(718) 353-1400
NPI assigned
Aug 12, 2021
Last updated
Feb 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 045667 NY Primary

Addresses

Primary practice location

140-40 Sanford Avenue
Queens, NY 11355-2556

Mailing address

8808 Justice Ave Apt 9N
Elmhurst, NY 11373-5338
Phone (916) 895-4726

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628004091 CA Practitioner - Physical Therapist in Private Practice 5597150649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045667NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehab Inc Physical Therapist CurrentSince Jul 1, 2023 Accepting new patients
My Medical PC CurrentSince Mar 24, 2022 Accepting new patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Jul 1, 2023 Accepting new patients
Ats Rehab OT & PT & SLP PLLC Physical Therapist CurrentSince Nov 24, 2022 Accepting new patients

Locations

2950 Sierra Sunrise Ter
Chico, CA 95928
Phone (530) 941-1017

9000 Murray Dr
La Mesa, CA 91942
Phone (585) 451-4018

3900 Dale Rd
Modesto, CA 95356
Phone (209) 492-0128

177 Mary Ave
Nipomo, CA 93444
Phone (805) 600-3366

3499 Grande Vista Dr
Thousand Oaks, CA 91320
Phone (949) 485-2022

3210 Sepulveda Blvd
Torrance, CA 90505
Phone (424) 488-6340

1105 E County Line Rd
Ste 213
Lakewood, NJ 08701

3438 Bell Blvd
Ste 301
Bayside, NY 11361

2830 Pitkin Ave
Brooklyn, NY 11208
Phone (347) 420-8295

10825 Horace Harding Expy
Flushing, NY 11368
Phone (516) 216-4108

8008 45th Ave
Flushing, NY 11373
Phone (718) 373-0777

274 W Broadway
Long Beach, NY 11561
Phone (516) 431-1400

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

Organizations & group practices 4

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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1639844434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8808 JUSTICE AVE APT 9N",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735338",
            "telephone_number": "916-895-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140-40 SANFORD AVENUE",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "113552556",
            "telephone_number": "718-353-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTIPUESTO",
        "first_name": "KIA NICHOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.