Agnes Leonia Van De Put, PT in Sebastopol, CA - Medicare Physical Therapist In Private Practice Provider

Agnes Leonia Van De Put, PT is a medicare enrolled "Physical Therapist" provider in Sebastopol, California. She graduated from medical school in 2018 and has 8 years of diverse experience with area of expertise as Physical Therapist In Private Practice. Her current practice location is 6914 Sebastopol Ave, Sebastopol, California. You can reach out to her office (for appointments etc.) via phone at (707) 327-0998.

Agnes Leonia Van De Put is licensed to practice in California (license number 25323) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1588812721.

Contact Information

	Agnes Leonia Van De Put, PT
	6914 Sebastopol Ave, Sebastopol, CA 95472-3459
	(707) 327-0998
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Agnes Leonia Van De Put
Gender	Female
Speciality	Physical Therapist In Private Practice
Experience	8 Years
Location	6914 Sebastopol Ave, Sebastopol, California
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Agnes Leonia Van De Put graduated from medical school in 2018

NPI Data:

NPI Number: 1588812721
Provider Enumeration Date: 08/29/2008
Last Update Date: 09/06/2023

Medicare PECOS Information:

PECOS PAC ID: 9234292699
Enrollment ID: I20230927001881

Medical Identifiers

Medical identifiers for Agnes Leonia Van De Put such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588812721	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	2160 (Hawaii)	Secondary
225100000X	Physical Therapist	25323 (California)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Agnes Leonia Van De Put is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Agnes Leonia Van De Put, PT 7809 Stefenoni Ct Unit A, Sebastopol, CA 95472-3536 Ph: (808) 937-3943	Agnes Leonia Van De Put, PT 6914 Sebastopol Ave, Sebastopol, CA 95472-3459 Ph: (707) 327-0998

Reviews and Comments

Physical Therapist in Sebastopol, CA

Paula Tanksley, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 130 Petaluma Ave, Ste 2-g, Sebastopol, CA 95472 Phone: 707-888-5093 Fax: 707-222-6572
Teresa L Burk, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Pleasant Hill Ave N, Sebastopol, CA 95472 Phone: 707-829-3282
Kathy Mcconnell, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Pleasant Hill Ave N, Sebastopol, CA 95472 Phone: 707-829-3282 Fax: 707-829-3287
Mrs. Samantha Marie Jacobs, M.S.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 100 Pleasant Hill Ave N, Sebastopol, CA 95472 Phone: 707-829-3282 Fax: 707-829-3287
Elyse Detweiler Mccluskey, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 100 Pleasant Hill Ave N, Sebastopol, CA 95472 Phone: 707-829-3282 Fax: 707-829-3287
Patricia Donovan Martinez, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 100 Pleasant Hill Ave N, Sebastopol, CA 95472 Phone: 707-829-3282 Fax: 707-829-3287
Olivia Kathleen Barry, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 8074 Yule Tree Ln, Sebastopol, CA 95472 Phone: 310-968-6809

Agnes Leonia Van De Put, PT - Medicare Physical Therapist in Sebastopol, CA