Active NPI
Michelle A Agostinoni, D.P.T.
- Physical Therapist
- Ravena, NY
National Provider Identifier
1801049028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 026356-1
- Practice address
- 14379 Route 9W
Ravena, NY 12143 - Phone
- (518) 756-3124
- Fax
- (518) 756-9476
- NPI assigned
- Oct 31, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 026356-1 | NY | Primary |
| Early Intervention Provider Agency | 252Y00000X | 026356-1 | NY |
Addresses
Primary practice location
14379 Route 9W
Ravena, NY 12143
Mailing address
537 Route 9W
Glenmont, NY 12077-3703
Phone (518) 436-7888
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
| License | State | Type | Specialty |
|---|---|---|---|
| 026356-1 | NY | MD | Early Intervention Provider Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Early Childhood Learning Center, Inc. | Early Intervention Provider Agency | 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 and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Ravena, NY
- NPI 1336392216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339632000000",
"number": "1801049028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "537 ROUTE 9W",
"city": "GLENMONT",
"state": "NY",
"postal_code": "120773703",
"telephone_number": "518-436-7888",
"fax_number": "518-462-9162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14379 ROUTE 9W",
"city": "RAVENA",
"state": "NY",
"postal_code": "12143",
"telephone_number": "518-756-3124",
"fax_number": "518-756-9476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGOSTINONI",
"first_name": "MICHELLE",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "D.P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-31",
"last_updated": "2012-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "026356-1",
"primary": true
},
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": "NY",
"license": "026356-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ravena, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.