Individual provider Active NPI

Venise Mule-Glass, PT

  • Physical Therapist
  • Commack, NY
National Provider Identifier
1720061773
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5744-1 Issued in NY
Practice address
297 Commack Rd
Commack, NY 11725-3401
Phone
(631) 499-1038
Fax
(631) 499-2293
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5744-1 NY Primary
Neurology Physical Therapist 2251N0400X 5744-1 NY
Orthopedic Physical Therapist 2251X0800X 5744-1 NY

Addresses

Primary practice location

297 Commack Rd
Commack, NY 11725-3401

Mailing address

297 Commack Rd
Commack, NY 11725-3401
Phone (631) 499-1038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080520000542 NY Practitioner - Physical Therapist in Private Practice 3476622283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

297 Commack Rd
Commack, NY 11725-3431
Phone (631) 499-1038

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as individual
Quality
74.88
Improvement activities
40
Cost
76.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5744-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Physical Therapy, PC Physical Therapist CurrentSince Jul 25, 1985 Accepting new patients

Locations

297 Commack Rd
Commack, NY 11725
Phone (631) 499-1038

Organizations & group practices 1

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1720061773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253401",
            "telephone_number": "631-499-1038",
            "fax_number": "631-499-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253401",
            "telephone_number": "631-499-1038",
            "fax_number": "631-499-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULE-GLASS",
        "first_name": "VENISE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "5744-1",
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NY",
            "license": "5744-1",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "5744-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.