Individual provider Active NPI

Eileen Patricia Duswalt-Agostino, M.S. P. T.

  • Physical Therapist
  • East Setauket, NY
National Provider Identifier
1851511877
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013718-1 Issued in NY
Practice address
3 Technology Dr
Suite 400
East Setauket, NY 11733-4064
Phone
(631) 751-8000
NPI assigned
May 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 013718-1 NY Primary

Addresses

Primary practice location

3 Technology Dr
Suite 400
East Setauket, NY 11733-4064

Mailing address

32 Tyburn LN
South Setauket, NY 11720-1426
Phone (631) 696-9222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180119000420 NY Practitioner - Physical Therapist in Private Practice 6709145758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Miami, LM Miller School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3480 Veterans Memorial Hwy
Bohemia, NY 11716-1068
Phone (631) 289-0338

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

Merit-based Incentive Payment System (MIPS)

Final score
81.25 of 100Reported as individual
Quality
77.94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
013718NYMDInternal Medicine Physician
013718-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jun 1, 2019 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Jun 1, 2019 Accepting new patients

Organizations & group practices 3

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851511877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 TYBURN LN",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117201426",
            "telephone_number": "631-696-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 TECHNOLOGY DR",
            "address_2": "SUITE 400",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334064",
            "telephone_number": "631-751-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSWALT-AGOSTINO",
        "first_name": "EILEEN",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "M.S. P. T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013718-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.