Individual provider Active NPI

Jennifer Nicole McDonough

  • Physical Therapy Clinic/Center
  • Farmington, CT
National Provider Identifier
1770008971
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Practice address
499 Farmington Ave
Farmington, CT 06032-1943
Phone
(860) 549-8986
NPI assigned
Aug 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

499 Farmington Ave
Farmington, CT 06032-1943

Mailing address

23 Celeste Ave
Holbrook, NY 11741-3713

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180611002366 NY Practitioner - Physical Therapist in Private Practice 8921364597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

144 E 44TH St
Suite 303
New York, NY 10017-4008
Phone (212) 973-0655

44 Saint Marks PL
New York, NY 10003-8118
Phone (212) 529-5966

Merit-based Incentive Payment System (MIPS)

Final score
77.3 of 100Reported as individual
Quality
73.3
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042879NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapy CurrentSince Jun 1, 2018 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapy CurrentSince Jan 1, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC CurrentSince Jun 1, 2018 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jan 1, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Current Accepting new patients

Locations

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

90 Northern Blvd
Greenvale, NY 11548
Phone (516) 626-5080

576 Broadhollow Rd
Melville, NY 11747

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

144 E 44th St
Ste 303
New York, NY 10017
Phone (212) 973-0655

16 E 52nd St
Fl 6
New York, NY 10022
Phone (212) 752-2400

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 5

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": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1770008971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CELESTE AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117413713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321943",
            "telephone_number": "860-549-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; 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.