Individual provider Active NPI

Antara Doris Quinones, DPT

  • Physical Therapist
  • Missoula, MT
National Provider Identifier
1649538893
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4356 Issued in MT
Practice address
2965 Stockyard Rd
Missoula, MT 59808-1557
Phone
(406) 541-2606
Fax
(406) 541-2607
NPI assigned
Apr 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X MT
Physical Therapist 225100000X 4356 MT Primary

Addresses

Primary practice location

2965 Stockyard Rd
Missoula, MT 59808-1557

Mailing address

5000 Blue Mountain Rd
Missoula, MT 59804-9213
Phone (406) 251-2323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121010000247 MT Practitioner - Physical Therapist in Private Practice 4688823594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5000 Blue Mountain Rd
Missoula, MT 59804-9213
Phone (406) 251-2323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4356MTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dodge Works PT, Inc Dba Alpine Physical Therapy Physical Therapist CurrentSince Jul 12, 2012 Accepting new patients
Dodge Works PT, Inc Dba Alpine Physical Therapy Physical Therapist CurrentSince Jul 12, 2012 Accepting new patients

Locations

5000 Blue Mountain Rd
Missoula, MT 59804
Phone (406) 251-2323

2965 Stockyard Rd
Missoula, MT 59808
Phone (406) 251-2323

1510 S Reserve St
Missoula, MT 59801
Phone (406) 251-2323

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": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1649538893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BLUE MOUNTAIN RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598049213",
            "telephone_number": "406-251-2323",
            "fax_number": "406-251-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 STOCKYARD RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081557",
            "telephone_number": "406-541-2606",
            "fax_number": "406-541-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES",
        "first_name": "ANTARA",
        "middle_name": "DORIS",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "4356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; 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.