Individual provider Active NPI

Michelle Valerie Agostini, P.T., D.P.T.

  • Physical Therapist
  • Jersey City, NJ
National Provider Identifier
1902269244
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01485400 Issued in NJ
Practice address
111 Hancock Ave Apt 1
Jersey City, NJ 07307-2160
Phone
(570) 947-0400
NPI assigned
Apr 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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 40QA01485400 NJ Primary

Addresses

Primary practice location

111 Hancock Ave Apt 1
Jersey City, NJ 07307-2160

Mailing address

111 Hancock Ave Apt 1
Jersey City, NJ 07307-2160
Phone (570) 947-0400

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40QA01485400NJMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1902269244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HANCOCK AVE APT 1",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072160",
            "telephone_number": "570-947-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HANCOCK AVE APT 1",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072160",
            "telephone_number": "570-947-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTINI",
        "first_name": "MICHELLE",
        "middle_name": "VALERIE",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01485400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.