Jonathan Adam Venegas, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

015585-1 Issued in NY

Practice address

1651 Bellmore Ave
North Bellmore, NY 11710-5526

Phone

(516) 781-1085

Fax

(516) 781-1013

NPI assigned

Nov 9, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Boston University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pro Performance Physical Therapy and Wellness, PLLCGroup PAC ID 9830263631, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pro Performance Physical Therapy and Wellness, PLLC

  • Orthopedic Physical Therapist
  • Glen Cove, NY
  • NPI 1821262809
  Medicare reassignment Care Compare group NPD Authorized official
• Achieve Physical Therapy and Wellness

  • Physical Therapist
  • North Bellmore, NY
  • NPI 1811050818
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962572552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 RELLIM DR",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115424023",
            "telephone_number": "516-801-0779",
            "fax_number": "516-781-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 BELLMORE AVE",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117105526",
            "telephone_number": "516-781-1085",
            "fax_number": "516-781-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEGAS",
        "first_name": "JONATHAN",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015585-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A3394616",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1877505",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tiny Kannadan Varghese, M.D.
• Selin Varughese, LCSW
• Drew Velting, PH.D.
• Felicia Vinci, PT
• Kaitlyn Virgona, PA-C
• Vital Core Medical Supplies Inc
• Walgreen Co (Walgreens #06334)
• Walgreen Co (Rite Aid)

• Physical Therapist in North Bellmore, NY
• Providers in North Bellmore, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.