Mars Antonio Medina, PT
Individual provider Active NPI Physical Therapist · Congers, NY
NPI 1760664106 · NPPES record last updated May 29, 2015
Key facts
- NPI
- 1760664106
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 026132-1 (NY)
- Practice address
- 25 Hemlock Dr
Congers, NY 10920-1401 - Phone
- (845) 267-0110
- Fax
- (845) 267-2634
- NPI assigned
- Nov 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arc Healthresources of Rockland Inc
Practice addresses (Care Compare)
70 Phillips Hill Rd
New City, NY 10956-4114
Phone (845) 267-0110
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080115000381 | NY | Practitioner - Physical Therapist in Private Practice | 1254412356 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026132-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arc Healthresources of Rockland, Inc. | Physical Therapist | Current |
Accepting new patients |
Locations
25 Hemlock Dr
Congers, NY 10920
Phone (845) 267-0110
70 Phillips Hill Rd
New City, NY 10956
Phone (845) 267-0110
210 Route 303
Vly Cottage, NY 10989
Phone (845) 267-0110
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 026132-1 | NY | Yes |
Addresses
Primary practice location
25 Hemlock Dr
Congers, NY 10920-1401
Mailing address
785 Sequoia Dr
Valley Cottage, NY 10989-1910
Other providers in Congers, NY
- Marie C Leto
- Sherry Llauger
- Vilma Marin
- Rekha Nevin Mathew
- Sruti Mathur
- Vivette Mednard
- Elizabeth Anne Messmer
- Wesley Miller
- Melissa W Moreno I
- Lori Neil
All providers in Congers, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.