Individual provider Active NPI

Devon Kuntzsch

  • Physical Therapist
  • Ridge, NY
National Provider Identifier
1891332102
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045265-01 Issued in NY
Practice address
679 Whiskey Rd
Ridge, NY 11961-8352
Phone
(631) 821-8090
Fax
(631) 821-8366
NPI assigned
Dec 5, 2019
Last updated
Dec 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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 045265-01 NY Primary

Addresses

Primary practice location

679 Whiskey Rd
Ridge, NY 11961-8352

Mailing address

679 Whiskey Rd
Ridge, NY 11961-8352
Phone (631) 821-8090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200608002167 NY Practitioner - Physical Therapist in Private Practice 8325469935 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, shared by 41 NPIs, 5,925 clinicians

Practice addresses (Care Compare)

322 W Main St
Patchogue, NY 11772-3008
Phone (631) 228-4977

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Merit-based Incentive Payment System (MIPS)

Final score
77.35 of 100Reported as group
Quality
73.31
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045265-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Advantage Physical Therapy PC Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC Physical Therapist CurrentSince Aug 31, 2020 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Jun 10, 2024 Accepting new patients

Locations

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

322 W Main St
Patchogue, NY 11772
Phone 5167458070520

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

679 Whiskey Rd
Ridge, NY 11961
Phone (631) 821-4313

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": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1891332102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 WHISKEY RD",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119618352",
            "telephone_number": "631-821-8090",
            "fax_number": "631-821-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 WHISKEY RD",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119618352",
            "telephone_number": "631-821-8090",
            "fax_number": "631-821-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNTZSCH",
        "first_name": "DEVON",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045265-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.