Active NPI
Douglas Vanella
- Physical Therapist
- Great Neck, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 62038489
- Practice address
- 475 Northern Blvd Ste 11
Great Neck, NY 11021-4802 - Phone
- (516) 829-0030
- Fax
- (516) 466-7723
- NPI assigned
- Nov 20, 2014
- Last updated
- Feb 19, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 62038489 | NY | Primary |
Addresses
Primary practice location
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Mailing address
315 Arthur St
Freeport, NY 11520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Boundary Ave
Suite 300
Massapequa, NY 11758-1152
Phone (516) 249-3760
415 Crossways Park Dr
Suite E
Woodbury, NY 11797-2055
Phone (516) 838-8400
44 Saint Marks PL
New York, NY 10003-8118
Phone (212) 529-5966
Merit-based Incentive Payment System (MIPS)
- Final score
- 77.16 of 100
- Quality
- 70
- Improvement activities
- 40
- Cost
- 78.87
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62038489 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC | Physical Therapist | Current | Accepting new patients |
| Sports Physical Therapy Occupational Therapy and Rehabilitation Servic | Current | Accepting new patients | |
| Sports Physical Therapy Occupational Therapy and Rehabilitation Servic | Physical Therapist | Current | Accepting new patients |
Locations
801 Merrick Ave
East Meadow, NY 11554
Phone (516) 393-8900
800 E Gate Blvd
Garden City, NY 11530
1000 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 466-4700
50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545
9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212
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.
-
- Hand Physical Therapist
- East Meadow, NY
- NPI 1770540593
-
- Occupational Therapist
- Garden City, NY
- NPI 1356742365
Physical Therapist
-
- Occupational Therapist
- White Plains, NY
- NPI 1629825591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424304000000",
"number": "1962809988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 ARTHUR ST",
"city": "FREEPORT",
"state": "NY",
"postal_code": "11520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 NORTHERN BLVD STE 11",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110214802",
"telephone_number": "516-829-0030",
"fax_number": "516-466-7723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANELLA",
"first_name": "DOUGLAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-20",
"last_updated": "2015-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "62038489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.