Active NPI
Nicole M Aquino, DPT
- Physical Therapist
- Patchogue, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 041059
- Practice address
- 77 Medford Ave
Patchogue, NY 11772-1281 - Phone
- (631) 758-1910
- Fax
- (631) 758-1984
- NPI assigned
- Oct 23, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 041059 | NY | Primary |
Addresses
Primary practice location
77 Medford Ave
Patchogue, NY 11772-1281
Mailing address
712 Main St
Islip, NY 11751-3620
Phone (631) 666-3951
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041059 | Other | NY | NY STATE EDUC DEPT |
Other names 1
- Nicole M Gallo
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181030000301 | NY | Practitioner - Physical Therapist in Private Practice | 8325391949 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- New York University
Practice addresses (Care Compare)
111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700
877 E Main St
Suite 106
Riverhead, NY 11901-2521
Phone (631) 727-0660
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- Quality
- 91.79
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.18
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients |
Locations
712 Main St
Islip, NY 11751
Phone (631) 666-3939
77 Route 112
Patchogue, NY 11772
Phone (631) 207-2370
13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
877 E Main St
Ste 106
Riverhead, NY 11901
Phone (631) 727-0660
1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Organizations & group practices 2
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.
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540252800000",
"number": "1861968372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 MAIN ST",
"city": "ISLIP",
"state": "NY",
"postal_code": "117513620",
"telephone_number": "631-666-3951",
"fax_number": "631-666-3994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 MEDFORD AVE",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "117721281",
"telephone_number": "631-758-1910",
"fax_number": "631-758-1984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AQUINO",
"first_name": "NICOLE",
"middle_name": "M",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-23",
"last_updated": "2018-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "041059",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY STATE EDUC DEPT",
"identifier": "041059",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "GALLO",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Patchogue, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.