Individual provider Active NPI

Adrian Neil Agustin, P.T.

  • Physical Therapist
  • Macon, MO
National Provider Identifier
1922235100
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
118096 Issued in MO
Practice address
701 Sunset Hills Dr
Macon, MO 63552-2165
Phone
(660) 385-1625
Fax
(660) 385-1625
NPI assigned
Jun 16, 2009
Last updated
Sep 14, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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 118096 MO Primary

Addresses

Primary practice location

701 Sunset Hills Dr
Macon, MO 63552-2165

Mailing address

701 Sunset Hills Dr
Macon, MO 63552-2165
Phone (660) 385-1625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150210001855 MO Practitioner - Physical Therapist in Private Practice 4486979663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Physical Therapy PCGroup PAC ID 9335190339, 27 clinicians

Practice addresses (Care Compare)

1306 US Hwy 63
Queen City, MO 63561-2251
Phone (877) 870-4976

1926 Oak St
Unionville, MO 63565-1180
Phone (977) 870-4976

3333 W 10TH St
Mid America Physical Therapy
Sedalia, MO 65301-2113
Phone (877) 870-4976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118096MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
NHC Healthcare-Macon LLC Past Accepting new patients
Key Rehabilitation, Inc Past 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": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1922235100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 SUNSET HILLS DR",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635522165",
            "telephone_number": "660-385-1625",
            "fax_number": "660-385-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SUNSET HILLS DR",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635522165",
            "telephone_number": "660-385-1625",
            "fax_number": "660-385-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTIN",
        "first_name": "ADRIAN",
        "middle_name": "NEIL",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "118096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.