Individual provider Active NPI

Jenna M Sanantonio, PT

  • Physical Therapist
  • Harrison, NY
National Provider Identifier
1750796900
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
035106 Issued in NY
Practice address
550 Mamaroneck Ave
Ste 104
Harrison, NY 10528-1634
Phone
(914) 777-3737
Fax
(914) 777-0914
NPI assigned
Jun 26, 2014
Last updated
Jun 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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 035106 NY Primary

Addresses

Primary practice location

550 Mamaroneck Ave
Ste 104
Harrison, NY 10528-1634

Mailing address

4175 Veterans Memorial Hwy
Ronkonkoma, NY 11779-7639
Phone (631) 580-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035106NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Physical Therapist Past Accepting new patients

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, 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": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1750796900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 VETERANS MEMORIAL HWY",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797639",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MAMARONECK AVE",
            "address_2": "STE 104",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105281634",
            "telephone_number": "914-777-3737",
            "fax_number": "914-777-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANANTONIO",
        "first_name": "JENNA",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.