Individual provider Active NPI

Jorge Abel Sanchez Pena

  • Physical Therapist
  • Hauppauge, NY
National Provider Identifier
1912677139
Registry record updated Jan 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
611 Old Willets Path Ste 105
Hauppauge, NY 11788-4115
Phone
(631) 232-5350
NPI assigned
Sep 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2022

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 Primary

Addresses

Primary practice location

611 Old Willets Path Ste 105
Hauppauge, NY 11788-4115

Mailing address

80 Fillmore Ave
Deer Park, NY 11729-7004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220207001557 NY Practitioner - Physical Therapist in Private Practice 8426441882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9525 Queens Blvd
Suite 3D
Rego Park, NY 11374-4510
Phone (718) 925-6212

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047597NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Aug 13, 2024 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Jul 2, 2023 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jul 2, 2023 Accepting new patients
Body in Balance Physical Therapy Physical Therapist CurrentSince Nov 3, 2021 Accepting new patients

Locations

12 Technology Dr
Unit 2
East Setauket, NY 11733
Phone (631) 232-5350

611 Old Willets Path
Ste 105
Hauppauge, NY 11788
Phone (631) 232-5350

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1631923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641600000000",
    "number": "1912677139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 FILLMORE AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117297004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 OLD WILLETS PATH STE 105",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117884115",
            "telephone_number": "631-232-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ PENA",
        "first_name": "JORGE",
        "middle_name": "ABEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-18",
        "last_updated": "2022-01-08",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; 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.